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Valens

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Forms

Forms

Initial Evaluation Questionnaire

Type: docx


Notice of Privacy Practices

Type: pdf


Direct Access (Required if you do not have a referral to physical therapy from another medical provider)

Type: doc


Insurance Summary

Type: doc


Guide to Insurance Verification

Type: doc


Outcome Tools

These questionnaires are body region specific and help your physical therapist convey the “medical necessity” of your physical therapy services in communication with your insurance company.

Please fill out the form most related to your region of concern. If you have difficulty selecting a form, one will be provided at your initial evaluation.

Neck

Type: pdf


Shoulder

Type: pdf


Hand / Elbow

Type: pdf


Unspecified Upper Body Concerns

Type: pdf


Low Back

Type: pdf


Hip

Type: pdf


Knee

Type: pdf


Foot / Ankle

Type: pdf


Unspecified Lower Extremity Concerns

Type: pdf


Balance

Type: pdf


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Our Location

Valens office building as seen from the street

Directions

Located inside the beltway at 1501 Duke Street in Alexandria, Virginia, our office is convenient to Washington, DC and surrounding areas. Click below for a map and directions.

GET DIRECTIONS

1501 DUKE ST. SUITE 150, ALEXANDRIA, VA 22314

Phone: 703.535.5491
Fax: 703.535.5494
Hours: 7am-8pm
info@valensphysicaltherapy.com

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  • FAQ
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