HOME    |    ABOUT ACTIVE    |    SERVICES    |    NEW PATIENTS    |    STORIES OF HOPE    |    EMPLOYMENT    |    CONTACT
FORM DOWNLOADS
Medical History 1
Medical History 2
Med History Current Symptoms
Insurance Information Form
Disclosure Statement
Notice of Privacy Practices
Attendance & Cancellation Policy
Acknowledgement of NoPP

New Patient Info & Forms

Please Note : In the state of Michigan, a physician referral is required for physical therapy. Please contact Active Physical Therapy and Wellness for details regarding this issue.

What to bring for your first visit
Please be sure to bring your drivers license, insurance card and your referral form from your physician.

Most insurance plans accepted including
   
 

ACS Federal Workers Comp
Aetna
Auto
Blue Care Network
Blue Cross Blue Shield of MI
Blue Cross Blue Shield of MI Medicare Advantage
Cigna
Empire Blue Cross Blue Shield (Orthonet)
Health Alliance Plan (HAP)
          HAP Preferred, HAP HMO, HAP Medicare Advantage
Health Plus of Michigan
HealthPlus PPO
HealthPlus Senior (Medicare Advantage)
McLaren Health Advantage
Medicaid (secondary) not primary
          Medicaid HMO’S:
          Health Plan of MI
          HealthPlus Partners
          McLaren Health Plan
          Molina Healthcare
          Total Health Care
Medicare
Medicare Railroad
PPOM (Advantus)
          Cofinity
Tricare (Healthnet)- Standard, Prime Network
United Healthcare ACN (OptumHealth)
Workers Compensation



 
Site design by Ensley Creative