Welcome to Southside Physical Therapy. We know that you have a choice in where you go for treatment and we would like to thank you for selecting us.

Download Patient Forms

To save time, you may download and print all of the new patient information forms.

  1. Download Patient's Authorization to Disclose Medical Records Form

  2. Download Patient Information Form

  3. Download Symptom Form

  4. Download Condition Questionnaire

  5. Download Notice of Privacy Practices

You will need Adobe Acrobat Reader in order to view and print the forms, if you do not have Adobe Acrobat Reader you can download it by clicking on the icon below:

Get Adobe Acrobat Reader

Our Commitment to You Includes:

  1. Timely and appropriate individualized treatment in a healing environment to speed your recovery and your return to work and play.
  2. First visits are usually one hour in length. Other appointments will average 50 minutes.
  3. Experienced and educated professional staff who stay up to date on treatment techniques by regularly attending continuing education and reading professional literature.
  4. Written therapy evaluations, progress notes and discharge summaries are sent to your referring physician showing your therapy gains and progress toward goals. Telephone calls and other contact will be made as necessary.
  5. As a courtesy to you, we are happy to bill your primary and secondary insurance companies (provided we have all the necessary information) to keep your paperwork to a minimum. Please keep in mind that ultimately you are financially responsible for the cost of your treatment.
  6. Payment plans are available in limited situations. Before you get in a past-due status, please contact our front office billing staff. If you are being treated on a cash basis, payment is required at the time of your visit.

Your Responsibilities Include:

  1. Please do your home program exercises and follow the guidelines given by your therapist. Exercises do not work if you do not do them!
  2. Be on time for your appointment. We are ready and waiting for you.
  3. Cancel any appointments 24 hours in advance. We are saving the hour for you.
  4. Let us know if your insurance changes so we can take care of the billing appropriately.
  5. Fill out the Symptom Form. We need to know what hurts, where and how much.
  6. Insurance co-payment is expected on the day of treatment.
  7. Any equipment / therapy supplies need to be purchased on the day you want to take them home.

Cancellation Policy

Call us 24 hours in advance if you are not going to make it to an appointment. We understand that you will get sick or have emergencies, but these are exceptions. Without 24-hours notice, we will bill you for your appointment. The fee is $80. Insurance companies do not cover no-show charges.

Late Appointments

We understand that issues arise, but please call if you are going to be late. The charge for late appointments is $35 for each 15 minutes that you are late.

Thank you for choosing Southside Physical Therapy. We would like to hear your suggestions for providing exceptional care in a comfortable environment.


Please Bring the Following with You to Your First Appointment:

1) Completed new patient forms.

2) The prescription for physical therapy from your doctor (if your insurance requires one).

3) Your medical insurance card or any other insurance billing information.

Copyright © Southside Physical Therapy Inc., Bend, OR 2000 - 2006. All rights reserved.