Understanding Prescription Requirements

Prescription Requirements

Your Rx for PT must include the following fields. All information provided must also match what is on your insurance card.

Required Fields

• First and Last name
• Patient Date of Birth
• The Duration and Frequency of Treatment -- Can list "PRN/PT discretion"
• A Valid Diagnosis -- Note: "Pelvic Floor PT" is not a valid diagnoses
• Provider Signature -- Written or Electronically, not stamped, unless signed with stamp
• Date of Rx/Referral