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2322 Powell St, Emeryville, CA
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(510) 653-5151
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CALIFORNIA LAW REQUIRES US TO COMPLY WITH CERTAIN RULES RELATED TO DIRECT ACCESS.
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IF YES , PLEASE PROVIDE THE INFORMATION:
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YOU ARE RECEIVING DIRECT PHYSICAL THERAPY TREATMENT SERVICES FROM AN INDIVIDUAL WHO IS A PHYSICAL THERAPIST LICENSED BY THE PHYSICAL
THERAPY BOARD OF CALIFORNIA.
UNDER CALIFORNIA LAW, YOU MAY CONTINUE TO RECEIVE DIRECT PHYSICAL THERAPY TREATMENT SERVICES FOR A PERIOD OF UP TO 45 CALENDAR
DAYS OR 12 VISITS, WHICHEVER OCCURS FIRST.
AFTER 45 DAYS OR 12 VISITS A PHYSICAL THERAPIST MAY CONTINUE PROVIDING YOU WITH PHYSICAL THERAPY TREATMENT SERVICES ONLY AFTER
RECEIVING EITHER A MEDICAL PRESCRIPTION OR SIGNED PLAN OF CARE FROM A DOCTOR.
IN SPECIFIC, THE DOCTOR MUST BE A PERSON HOLDING A PHYSICIAN OR SURGEON’S CERTIFICATE ISSUED BY THE MEDICAL BOARD OF CALIFORNIA OR BY
THE OSTEOPATHIC MEDICAL BOARD OF CALIFORNIA, OR FROM A PERSON HOLDING A CERTIFICATE TO PRACTICE PODIATRIC MEDICINE FROM THE
CALIFORNIA BOARD OF PODIATRIC MEDICINE. YOU MUST SEE THE PHYSICIAN IN PERSON.
AS A MATTER OF TIMING, WE RECOMMEND THAT YOU PLAN TO VISIT YOUR DOCTOR WITHIN A FEW WEEKS OF STARTING PHYSICAL THERAPY OR EMAIL
YOUR PHYSICIAN TO COMMUNICATE THE INFORMATION.
KIND REGARDS,
EMERYVILLE SPORTS PHYSICAL THERAPY MANAGEMENT