Crystal Lake Physical Therapy
  • Home
  • About Us
    • Our Staff
    • Our Practice
    • Our Location
  • What We Treat
    • Arthritis
    • Balance and Gait Disorders
    • Back Pain and Sciatica
    • Chronic Pain
    • Elbow, Wrist and Hand Pain
    • Fibromyalgia
    • Hip and Knee Pain
    • Incontinence
    • Motor Vehicle Accident Injuries
    • Multiple Sclerosis
    • Neck Pain
    • Pelvic Pain
    • Pre-Surgical Rehab
    • Post Surgical Rehab
    • Shoulder Pain
    • Sports Injuries
    • TMJ Dysfunction
    • Vestibular Rehab
    • Work Injuries
    • Myofascial Release
    • MPS/Dolphin Neuro Stim
  • Become A Patient
    • Patient Info/Forms
    • Direct Access
    • Telemedicine
    • Love Your Core Like Before
  • Contact Us
    • Contact Us
    • Write A Testimonial
    • Leave Us A Review
  • Blog
  • Workshops
  • Newsletters
  • Patient Resources
Patient Intake Form
At Crystal Lake Physical Therapy Inc. we want to maximize your time with us. Prior to your first visit, please fill out the new patient intake form below and submit it. Also, bring along proof of ID along with your insurance information.

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.

Location

What Our Clients Are Saying

"Friendly and professional staff. Cheerful atmosphere."

"I can not tell you how happy I am to have found Emily and Tara at Crystal Lake Physical Therapy. They are so friendly and truly care about quality care."

Contact Us

  • Home
  • About Us
    • Our Staff
    • Our Practice
    • Our Location
  • What We Treat
    • Arthritis
    • Balance and Gait Disorders
    • Back Pain and Sciatica
    • Chronic Pain
    • Elbow, Wrist and Hand Pain
    • Fibromyalgia
    • Hip and Knee Pain
    • Incontinence
    • Motor Vehicle Accident Injuries
    • Multiple Sclerosis
    • Neck Pain
    • Pelvic Pain
    • Pre-Surgical Rehab
    • Post Surgical Rehab
    • Shoulder Pain
    • Sports Injuries
    • TMJ Dysfunction
    • Vestibular Rehab
    • Work Injuries
    • Myofascial Release
    • MPS/Dolphin Neuro Stim
  • Become A Patient
    • Patient Info/Forms
    • Direct Access
    • Telemedicine
    • Love Your Core Like Before
  • Contact Us
    • Contact Us
    • Write A Testimonial
    • Leave Us A Review
  • Blog
  • Workshops
  • Newsletters
  • Patient Resources