New-Patient Registration Forms

Welcome New Patient!  We are pleased to assist you along your path to recovery.

Before we schedule your evaluation appointment, please scroll down on this page to the type of therapy you will be receiving and download your patient registration forms.  If you are unable to print the forms, please call us as soon as possible at (254) 699-3933 and we will mail them to you.

Please fill out your registration forms, and mail or drop them off at Integrity Rehab, located at 5302 Janelle Dr. Killeen, TX 76549 (next to McDonald’s off of S. Clear Creek Rd.).  We will then schedule your evaluation appointment at your earliest convenience.

When we schedule your appointment, we will go over with you what your insurance company will cover and any amounts you will be responsible for paying.  You still may want to call your insurance company prior to your appointment regarding coverage, deductibles and co-pays for outpatient therapy. 

Adult Physical Therapy Forms

	Adult Physical Therapy Patient Registration (Print & Complete)
	Policies for New Patients (Please Read)

Adult Pelvic-Floor Rehab Forms

	Introduction Letter & Policies (Please Read)
	Adult Pelvic Floor Patient Registration Forms (Print & Complete)

Adult Speech Therapy Forms

	Speech Therapy Patient Registration (Print & Complete)
	Policies for New Patients (Please Read)

Pediatric Physical, Occupational & Speech Therapy Forms

	Pediatric Patient Registration (Print & Complete)
	Policies for New Patients (Please Read)

Pediatric Pelvic-Floor Forms

	Pediatric Patient Registration (Print & Complete)
	Policies for New Patients (Please Read)

Referral Information
Integrity Rehab and Home Health requires a physician’s referral to provide physical therapy or home-health services. We make the referral process easy for doctors with simplified fax referrals. Click here for downloadable physician referral forms. We are also happy to contact your physician upon your request to help facilitate the referral.

Insurance Information
Integrity Rehab and Home Health is committed to helping people. With that in mind, we welcome just about every type of insurance large and small, including military and county coverage. Here is a list of the insurance plans we accept:

*We are considered out of network and/or we are not a preferred provider

Home Health Medicare Information
Medicare beneficiaries who qualify for home health pay nothing out of pocket for their home-health services from Integrity.

To qualify for Medicare-reimbursed home-health services, patients must:

• Be homebound – Leaving the home requires a taxing effort or the assistance of others and, as a results, occurs infrequently. Patients can be temporarily homebound as a result of injury or illness.
• Have a need for skilled nursing or therapy services – While personal care from aides is Medicare-covered, the need for this service alone does not justify a Medicare home health episode.

Patients’ doctors must certify their home health care, which Integrity Rehab and Home Health will coordinate directly with the physician.

Website of associations we are affiliated with
and resources for specific conditions.
American Physical Therapy Association
American Physical Therapy Association Section on Women's Health
American Speech-Language-Hearing Association
The American Occupational Therapy Association
American Nurses Association
National Association for Home Care & Hospice
American Urogynecologic Society
National Association for Continence
Interstitial Cystitis Association
Interstitial Cystitis Network
International Pelvic Pain Society
The Endometriosis Association
National Vulvodynia Association
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