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EVENTS CALENDAR

DIRECTIONS

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APPOINTMENT

IN THE NEWS

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LINKS

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Gift Certificates
Available

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Office Hours:
Monday to Friday
8 a.m. to 5 p.m.

910.794.2900 tel
910.313.0719 fax
Saturday Mornings
by Appointment

Early and Late
Appointments
Available,
Call to Schedule.

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 New Patient Forms:

We realize that it can be uncomfortable to fill out these necessary forms in our office,
so we have provided them here for download so that you can print them out, fill them
out at your leisure and bring them with you to our office.

If you have trouble with any questions, leave them blank and we can go over it when
you come into the office. We look forward to seeing you soon!
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If your appointment is
for BODYTALK please use
the form below:		 .................................................

If your appointment is
for PHYSICAL THERAPY,
please use the form below:
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As a courtesy to our patients, Holland Physical Therapy files primary insurance. Coverage
for physical therapy varies depending on the type of insurance coverage you have. Some
insurance companies require pre-certification, and some have a limit on the amount of physical
therapy visits you may receive. It is always advisable to call your insurance company and
find out the specific requirements regarding your coverage.


Holland Physical Therapy and BodyTalk accepts cash, check, Visa and MasterCard.
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Holland Physical Therapy • 5401 Wrightsville Avenue, Wilmington, NC 28403 • 910.794.2900
Willem Klokman, Licensed Physical Therapist and Certified BodyTalk Practitioner

©2010 Holland Physical Therapy, HollandTherapy.net and Willem Klokman, LPT, CBP
All Rights Reserved • Web content is for informational purposes only and not meant to diagnose • Webmaster

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