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South Burlington Physical Therapy
1879 Williston Road, South Burlington, VT 05403 - Phone 802.399.2318 - Fax 802.399.2505 - admin@sbptvt.com

South Burlington Physical Therapy

For the Lifestyle Athlete

  • About
    • Our Mission
    • Staff
      • Henry Mercier, MS, ATC
      • Casey Baczewski, DPT
  • Physical Therapy
    • Rehabilitation
    • Training Integration
    • Postural Restoration
    • Balance
    • Dance Rehab
    • Aquatic Therapy
    • Graston®
  • Dry Needling
  • Concussion
  • Resources
    • Insurance Information
    • New Patient Forms
    • FAQ
    • Friends of SBPT
    • Coach’s Corner
    • Exercise Library
  • Contact

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New Patient Forms

New Patient Forms

If you are a new patient, please download and fill out the following forms and bring them to your first visit.

Both Forms
Demographic
Health Intake Form

Body Part Questionnaire (Best Matches) 
Back
Shoulder
Neck
Falls
Arm/Elbow/Wrist
Hip/Knee/Ankle Survey 1
Hip/Knee/Ankle Survey 2
Headache

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Office Information

(P) 802.399.2318
(F) 802.399.2505
admin@sbptvt.com

Mon – Thur:  7 am – 6 pm

Fridays & Weekends available as needed.

Location

1879 Williston Road
Unit B
South Burlington, VT 05402

General Info

South Burlington Physical Therapy (SBPT) is an extension of Essex Physical Therapy. Therefore, all calls for information and scheduling with be through the Essex Physical Therapy Main Office. To contact the therapist at SBPT directly, please email at admin@sbpt.com.