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Patient Info

New Patient Information Form

Please fill out and print the form below, you can bring it along on your first visit or email it to adamfpt@msn.com

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2018-2019

2018-2019

Upledger Institute
Craniosacral CEUs

2012

2012

John Barnes Institute 

Myofascial Relaease

John Barnes Institute 

Myofascial Relaease

1999-2003

1999-2003

State University of NY at Buffalo

Bachelor's of Physical Therapy

Fees for Service

Adam Field Physical Therapy is an “out-of-network” provider for all insurance carriers. This allows us to concentrate on your health and healing process and determine an individualized plan according to your needs. The fee for the initial one-hour session is $90, and follow up 50-minute treatment sessions are $80.

Adam Field Physical Therapy accepts cash, checks, Flex, HAS, and FSA as well as all major credit cards. You pay for treatment the same day you are seen in the office and the payment may be reimbursed by your insurance carrier.

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Adam Field Physical Therapy will gladly provide you with the documentation and assistance you need to submit a claim to your insurance provider. Once you meet your “out-of-network” deductible, your insurance provider should send you a reimbursement check for all approved reasonable and customary treatments. While we do everything we can to assist you, we cannot guarantee that you will receive reimbursement.

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How to Determine Your Insurance Benefits for Physical Therapy (.pdf)

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Cancellation Policy

We request 24 hours notice for cancellations. Monday appointments must be cancelled by 4 p.m. on Saturday. Cancellations or “no shows” without advance notice will be charged $75.

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