Petersen Physical Therapy - 服务预约与评估项目清单

Sep 5, 2026

Upload by Quinn

Appointment and referral intake content for Petersen Physical Therapy locations in Arizona, including Tempe, Maricopa, Mesa, Gilbert/Chandler, and Neuro & Brain Performance Centers. Provides contact details, fax and website references, and instructions to call or fax to schedule visits and optimize healing by keeping scheduled appointments. Includes a medical-necessity style section with patient fields, diagnosis and ICD-10 entry, and a comprehensive list of evaluation and treatment services such as PT/OT, neuro rehab, speech therapy, ergonomics, weight loss, vestibular rehabilitation, testing, and specialized therapies.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Locations and Contact Information

Appointment Request and Scheduling Instructions

Patient Details and Diagnosis Fields

Medical Necessity and Referral Notes

Services and Treatment Options

Evaluate & Treat Categories

Specialized Therapies

□ Tempe/Mesa Petersen Physical Therapy 1844 E. Baseline Rd., Suite C-5 Tempe, AZ 85283 Phone: 480-833-1005 Fax: 480-833-1312 [www.petersenphysicaltherapy.com](www.petersenphysicaltherapy.com) □ City of Maricopa Petersen Physical Therapy 21300 N. John Wayne Pkwy. Suite 125 Maricopa, AZ 85139 Phone: 520-568-2723 Fax: 520-568-2865 [www.petersenphysicaltherapy.com](www.petersenphysicaltherapy.com) □ Gilbert/Chandler Carling Aquatic & Physical Therapy 725 W. Elliot, Suite 103 Gilbert, AZ 85233 Phone: 480-892-2428 Fax: 480-892-2418 [www.carlingphysicaltherapy.com](www.carlingphysicaltherapy.com) □ Mesa/North Mesa Petersen Physical Therapy 6840 E. Brown Rd. \#104 Mesa, AZ 85207 Phone: 480-779-4671 Fax: 480-981-8595 [www.petersenphysicaltherapy.com](www.petersenphysicaltherapy.com) □ Neuro Rehabilitation Center Neuro & Brain Performance Centers 6840 E. Brown Rd. \#104 Mesa, AZ 85207 Phone: 480-779-4671 Fax: 480-981-8595 [www.neuroandbrain.com](www.neuroandbrain.com) Please Call Or Fax To Make Your Appointment To optimize your healing, it is important to keep all your scheduled appointments Date: Patient Name: Patient Phone: Dx: ICD-10 Code: □ Evaluate & Treat □ Ergonomics □ Metabolic Weight Loss □ Neuro Rehab □ Speech Therapy □ Orthopedic PT/OT □ Vestibular Rehabilitation □ Orthotics □ Occupational Therapy □ ImPACT Testing □ Sports Therapy □ Aquatic Therapy □ ASTYM □ Anodyne Therapy □ Pediatrics □ Cold Laser □ FCE(Functional Capacity Evaluations) □ Dry Needling □ Graston Therapy □ Active Release Therapy □ LSVT (Big & Loud) □ EMG-Biofeedback □ QEEG Notes: Frequency & Duration 1 2 3 4 times per week for weeks. All the above treatment is medically necessary and indicated for this diagnosis. Referral for physical therapy/occupational therapy/speech therapy document of medical necessity. Signature: Petersen Physical Therapy Tempe Location US 60 | | Target
Store | | Baseline Dental/ Medical Center Petersen Physical Therapy Suite C-5
| | --- | --- | --- | --- | | | | | | | | | | | | | | | | Baseline Rd. 101/ Price Freeway Haze lton Ln . Petersen Physical Therapy City of Maricopa Location Carling Aquatic & Physical Therapy Gilbert Location Petersen Physical Therapy Mesa Location | Power Rd . | | | --- | --- | | | Brown Rd. | Neuro & Brain Performance Centers Neurological Rehabilitation– Mesa | Power Rd . | | | | --- | --- | --- | | | Brown Rd. | |

FAQs

Which types of evaluation and therapy services are listed?

Services include Evaluate & Treat options such as Ergonomics, Neuro Rehab, Speech Therapy, Orthopedic PT/OT, Vestibular Rehabilitation, Occupational Therapy, therapy testing, and multiple specialized therapy methods.

Sep 5, 2026

Upload by Quinn