Prescription Forms for Medical Providers Referring to Synergy

Prescription Forms

For Doctors and Doctor Offices

Prescription Forms

We have included this page for the benefit of doctors, nurses, physician assistants, and physician extenders.  We will accept prescription forms that are on our forms or on forms used by the office of the referral source.

Not all insurances require a prescription to receive physical therapy or occupational therapy, however, we do like to have a prescription on file so that we can substantiate the medical necessity of our services when they are reviewed by your insurance.

Doctors and Doctor Office, please click on this link to print out a prescription that you can use for your patients.

Thank you for your referral!

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