The staff at San Diego Sports Physical Therapy knows you have many choices for physical therapy care in the greater San Diego area. We relish the opportunity to help you not only physically but also in making sure you understand your health insurance benefits.

Health Insurances San Diego Sports Physical Therapy is in Network/Contracted with include:

  • Tricare/Triwest
  • United Healthcare
  • Blue Shield of California
  • Medicare
  • Cigna

We also accept “cash pay” on an as needed basis as well as working with you if we are out of network with your current health insurance carrier.

Prior to your first visit, please take time to fill out intake paperwork. Click on PDF icon to download and print PDF file forms. Thank you in advance for your assistance.


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Please Fill Out The Form Below:

Your Name*:
Describe briefly the history of your present ACCIDENT, INJURY, ILLNESS OR CONDITION:
Onset Date:
Please list any special concerns, questions or expectations:
Have you fallen in the past year?
If so, how many times?
If so, did you sustain an injury?
Have you had any physical therapy during the current calendar year?
Have you had physical therapy for the same condition for which you are here today?
If yes, please indicate where and when:
List ALL medications you are currently taking:
Please list recent diagnostic studies (CAT scan, MRI, X-ray, ETC.) & where taken:
Do you have METAL anywhere in your body (other than teeth), such as pins/plates, pacemaker, stints, etc.?
Please list ALL surgeries you have had; please give procedures and dates, if possible:
Have you ever had:
High blood pressure Yes No 
Heart disorders Yes No 
High Cholesterol Yes No 
Lung Disorders Yes No 
Circulation disorders Yes No 
Dizzy Spells Yes No 
Seizures Yes No 
Diabetes Yes No 
Arthritis/Osteoarthritis Yes No 
Osteoporosis Yes No 
Cancer Yes No 
Pacemaker Yes No 
Are you pregnant? Yes No 
Allergies to tapes or lotions? Yes No 
Tobacco use Yes No