Patient Forms

Thank you for choosing Vermont Physical Therapy! You’re one step closer to making major strides in your health and well-being. You may get the new patient intake packet by requesting an email. Please read all forms carefully, fill out appropriately and bring them with you to your initial appointment.

There are also download links to the six major functional scales we use. Please download and fill out the scale that mostly closely matches the main issue you are seeing us for (for example, use the “Upper Extremity” form for shoulder, arm, hand, etc.)

Your PT may have you fill out additional functional scales as needed. If you are unsure which scale to download, please call the office at (802) 497-0736 and we can guide you.

For All New Patients:

2025 Announcement

First and foremost, we want to express our heartfelt gratitude for your continued patronage and trust in Vermont Physical Therapy. It’s because of customers like you that our business has flourished, and we are able to continuously improve the quality of our services.

We are writing to inform you that as of January 1, 2025 (1/1/25), we will be implementing a price adjustment on our services/care. This change is necessary due to the overall increases in the cost of operations and to ensure that we can continue delivering the exceptional quality you’ve come to expect from us.

Details of New Pricing:

Out of Pocket (No Insurance/Out of Network) Initial Exams: $155

Out of Pocket (No Insurance/Out of Network) Follow Up Appointments: $120

Dry Needling done in physical therapy visit: $35

Dry Needling ONLY appointment: $60

We understand that changes in pricing might raise concerns, which is why we are committed to transparency. This price adjustment will allow us to maintain the high standards of our offerings and invest in the enhancements that add value to your experience with us.

We encourage you to reach out to us with any questions or concerns regarding this update. Our team is here to provide you with support and to discuss how we can continue serving you effectively during this transition.

Thank you once again for your understanding and continued support. We look forward to serving you now and in the future.

Warm Regards,

VTPT Family