Patient Info / Forms

Giuseppe I.
After my first visit the sciatic pain and limping symptoms virtually disappeared. I'm continuing as weaknesses are being worked on successfully.

Welcome to Mana Physical Therapy

We are here to help you enjoy your life, pain-free! To make a convenient appointment, simply call us today at 732-390-8100. Our practice is dedicated to helping our patients identify the cause of their pain and creating a custom treatment program that will allow them to return to normal activities pain-free.

What you can expect

At your first visit, you will be greeted by a member of our staff and fill out a few forms including your medical history. If you want to have them completed before your appointment, see below. If you have a prescription from your doctor and have imaging results that is helpful but not always necessary. Your therapist will then review your medical history and ask more questions regarding your condition to help guide the physical exam.

The physical exam will be extensive and the primary source of symptoms will be identified. Based on the results of your exam and other information provided, your therapist will create a customized plan of care for you. This will include manual therapy (hands-on care) and/or corrective exercise and other modalities.

Your plan of care will be continuously reviewed, evaluated and changed as your condition improves to help you meet your long-term goals. Long-term goals are patient specific and can include being able to enjoy a mile walk without knee pain as well as someone who needs to get back to sports without pain and more efficient movements.

Patient Forms

At Mana Physical Therapy, we want to maximize your time with us. Prior to your first visit, please complete the Intake Form and submit that online. Then print and fill out the New Patient Forms below, and bring it with you to your first visit along with your insurance information and photo ID. If you are unable to print the forms, please arrive 15 minutes prior to your scheduled appointment time.

Step 1: Online Intake Form

Please note that no personal information from this form will be stored on our website database. All information is securely directed and saved in our clinic’s Electronic Medical Record (EMR) system where all data is encrypted. The patient information will only be used by the clinic and will not be passed on to any third party.

Click here for Notice Of Privacy Practices

Step 2: Registration Packet

Before Your First Visit

  • Make a list of questions that you have to discuss on your first visit.
  • List signs and symptoms that can be of importance to the therapist.
  • Have in writing key past medical history, previous treatments, current medications, and other important information.
  • Please call our office to verify your insurance benefits.
  • Arrive 15 minutes early for your first appointment.
  • Bring with you a copy of your insurance card and a photo ID.

What to Expect on Your First Visit

  • You will register with our friendly front office staff. They will help you navigate the insurance process and treatment program so you can focus on your recovery.
  • You will meet with your physical therapist for the initial evaluation.
  • During the evaluation, your therapist will ask questions about your medical history, current pain, or injury. Open communication helps us understand your problem.
  • Your movement, strength, coordination, and much more will be evaluated. Our purpose is to help you, so please ensure you communicate to your therapist if anything is hurting or bothering you during the examination.
  • Your therapist will recommend and prepare a course of treatments to ensure the quickest recovery and the best results. Your therapist will discuss the recommendations with you.
  • There will be some treatments performed the first day to get you started on your road to recovery. However, during the next visit, you will get into the full swing of your treatment plan.
  • You will schedule your series of visits with the front desk. The amount of therapy needed will be discussed with you, depending on the recommendations of your therapist. We offer many convenient appointment times, however, prime times can become busy, so it is best to book ahead as much as possible.
  • Your therapist will write up their findings and treatment plan to submit to your referring physician or another medical professional who you choose.
  • If you have any questions at any time, please don’t hesitate to call. We want to ensure your satisfaction and full recovery.