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New Client Forms

New client documentation will be e-mailed to the client from Prompt EMR system through a fillable form via website link. Alternatively, pdf versions of new client forms are available below to be printed, completed, and submitted at the client’s first appointment if preferred. Paper forms are an additional option available to clients to be filled out at the clinic at the first appointment if preferred.

Consent to Treat

Financial Consent

Receipt of Privacy Practices

Privacy Practices

Location

2610 Trinity Dr Suite 16
Los Alamos, NM 87544

Hours

By Appointment

Empower Physical Therapy © 2023 All Rights Reserved

Contact

kellim@empowerptla.com
(505) 551-0523
Fax: (505) 570-4640

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