Appointments & Forms

Call to Schedule an Appointment: (703) 753-0261

Getting Started | Referrals | Consultation | Insurance | Expectations | FAQ

Getting Started

Haymarket Physical Therapy is Northern Virginia’s premier rehabilitation center. Our reputation for excellence stands year after year as satisfied patients recommend Haymarket Physical Therapy to their friends, families, and co-workers.

We provide treatment for adolescents and adults, women and men; whether you’re an amateur, professional or weekend athlete. Our quality care and expertise will help you lead a more independent and fulfilling life.

We look forward to helping you achieve Pain Free Motion!

What Should I Expect During My First Visit?

Required Paperwork

  • Our front office will send you intake forms prior to your first session. Please fill out and bring them with you to the first session. You may also download the required document below.
  • Each patient is required to submit their drivers license and insurance card (if applicable) to scan into your medical records.
  • Our front office staff will review your insurance benefits during the first treatment sessions, and answer any questions or concerns you may have.

Session Expectations

  • Your first visit usually takes 60-75 minutes from start to finish.
  • It will consist of a thorough history, examination, formulating a diagnosis, prognosis and Plan of Care.
  • If further imaging or labs are needed you will be referred out.
  • Routine visits usually last 45 minutes to an hour depending on condition.


  • Payment is due at the beginning of your session.
  • Payment types include cash, check and all major credit cards.
  • For self pay (for patients without insurance or for patients not using their health insurance):
    $125 New Patient appointments
    $100 Follow-up appointments

Good Faith Estimate Notice

You have the right to receive a “Good Faith Estimate” explaining how much your medical and mental health care will cost. Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the expected charges for medical services, including psychotherapy services. 

You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency healthcare services, including psychotherapy services. You can ask your healthcare provider, and any other provider you choose, for a Good Faith Estimate before you schedule a service. If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill. Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit

Fill Out the New Patient Forms

Covid 19 Questionnaire

New Patient Forms

New Patient Forms

Motor Vehicle New Patient Forms

Workers Comp New Patient Forms

Previous Patient/New Case Forms

Pain/Disability Scales

Lower Extremity

(knee, hip, ankle, foot)




Low back/lumbar

Arm / Shoulder / Hand

Shoulder, elbow, wrist, hand

All United Health Care & Aetna patients

Required by health insurance

Direct Access

Patients without RX’s & who have private insurance

Direct Access VA State Law

Direct Access Attestation

Notice of Privacy Practices

The Patient’s Guide to Understanding Insurance

Not Sure If Physical Therapy Is Right For You?

Stop Letting Pain Limit Your Life

Take advantage of our 30 minute Complimentary Consultation where you will get the following questions answered by a licensed Physical Therapist:

  • What is causing my pain?
  • Will physical therapy help?
  • What do I have to do to achieve pain free motion?
  • Do I need surgery?

Call us today to set up your discovery session. 

“I’m ready to get started:

I have a referral from my doctor.

You have everything you need to get started!

Please, fill out our new patient welcome packet and one of our medical receptionists will call to schedule your initial evaluation!

I don’t have a doctor referral.

No Problem! I’m ready to get started!

In the state of Virginia, Direct Access Laws allow you to receive treatment by a physical therapist for 30 days without a referral from your doctor, including patients with Medicare insurance.

This direct access* allows you to be treated earlier, resulting in quicker recovery and return to your normal activities. We will send a plan of care to the physician of your choice.

All you have to do is give us a call (703) 753-0261 to schedule your first appointment.

*Disclaimer: Although, Physical Therapists are allowed to treat patients without a physician referral, some insurance companies still require one for Physical Therapy coverage. Please contact our office if you have any questions or concerns if Direct Access is right for you.

Do you accept my Insurance?

In-Network Insurance
  • Carefirst
  • Anthem
  • Federal
  • BCBS
  • Medicare
  • Medicare Replacement
  • PHCS
  • MultiPlan
  • Aetna
  • Railrod Medicare
  • One Net
  • Golden Rule
  • Mail Handlers
  • United Health Care
  • Tricare/Tricare North
  • Optum
  • UMR
  • Motor Vehicle
  • Secure Horizons
  • Employee Benefits Systems
  • Workman’s Compensation
  • Stratose
  • Anthem Healthkeepers
  • VA Dept. of Veteran Affairs
Out-of-Network Providers
  • Kaiser Permanente
  • Humana Medicare
Don't have Insurance?

Don’t worry, we have programs just for you! Depending on the complexity of your condition. Call now to inquire about our cash pay options!

We offer special programs to people who meet the following criteria:

  • High Insurance Deductibles
  • HMO Insurance
  • No Insurance
  • Financial Hardship
  • Recently Unemployed
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