Patient Resources
Step 1: Book appointment: The link below will take you to our scheduling software, you can look at Dr. Woerner and Dr. Berry’s schedule to find a time that fits in your schedule. You can book on-line by filling out the information on the link. If you have questions regarding the appointments, you can call our office and speak to our office and they will be happy to assist you in booking your appointment over the phone. Our office number is 682-235-3816. To schedule an appointment online:
Schedule an Appointment* After an appointment is scheduled, you will receive a phone call to gather more information regarding demographic information, insurance and payment
Step 2: Obtain Referral: All Physical therapists in the state of Texas are required to have an Prescription signed by a provider with prescriptive rights as outlined in the Texas Physical Therapy Practice Act (TPTPA) to provide patient treatment. Providers with prescriptive rights according to TPTPA are: MD’s, DO’s, Certified Nurse Midwifes, Physician Assistants, Nurse Practitioners, Chiropractors, Dentists. Below is a form that you can have your provider fill out so that we can provide treatment after initial evaluation. If your doctor referred you to Woerner Physical Therapy, it is possible they have filled out the form and faxed it to us, in that case, you do not need to print the form. We can help you obtain a referral, if needed.
Physician Referral Form
Download Form
Step 3: Required Forms: There are forms that require signatures. Please download and print these forms and bring to your evaluation. We are happy to review these forms with you if you have any questions. If you are unable to print these forms, we have them available at the clinic.
- Financial Policies: These forms outline our policy regarding payments, filing insurance and patient responsibility.
- Patient Notice of Privacy: Form stating your rights as they pertain to your medical records and our responsibility of keeping your information confidential.
- Pelvic Floor Consent: If you are referred to our clinic for pelvic floor dysfunction, it may be beneficial to perform an assessment of the muscles of your pelvic floor by performing and internal exam. If you have questions or concerns regarding this method of evaluation, we will discuss at your visit.
- Functional Dry Needling: Functional Dry Needling is used to treat muscles with high tension. This may or may not apply to you, we can discuss this treatment in our visit session.
Step 4: At the clinic: There is one more step, when you arrive at the clinic, we have a computer tablet that goes through your medical history and current condition. This takes 10-15 minutes to complete, so by arriving to your appointment early, you will have time fill out the questions in order for us to have full time together.
Patient Forms
Woerner Physical Therapy Consent Form
Download Form
Functional Dry Needling®
Consent and Request for Procedure
Download Form
Insurance Eligibility Worksheet
Download Form
Physician Referral Form
Download Form
New Patient Forms
Pelvic Floor Informed Consent
Download Form
Patient Privacy Policies
Download Form
Financial Agreement
Download Form
Frequently Asked Questions
We currently accept Blue Cross Blue Shield, Medicare, and Tricare. Everyone’s policy is different with different coverages, deductibles and out of pocket expenses. We will contact BCBS, Medicare or Tricare to determine if there is a co-pay, co-insurance or deductible that needs to be met for your visits. These insurances determine what your portion of the treatment will be, for example, if we collect $150 for an initial evaluation and we file a claim to BCBS and they determine your portion is $160, Woerner Physical Therapy will send a statement for the additional $10 determined that you owe per your insurance company. These are contracted rates and are different for each individual plan.
If you have an insurance other than what is listed above, we can contact your insurance company to determine if you have any out of network benefits. Some policies have these benefits but some do not. We can also file on your out of network benefits so that your visit cost can go towards your out of network deductible.
If we file with your insurance, whether it is in network or out, we will add a $10 charge to our cash pay rate.
Many have the impression that we only treat women because they are the only ones with “pelvic problems.” Well, this is a sad misconception. We not only treat women during pregnancy, post-partum, and later in life for a variety of reasons, but we also treat men that are experiencing pelvic pain, incontinence, and/or constipation. We also treat kids that are experiencing constipation, pain or urinary symptoms.
In the state of Texas we are a partial direct access state meaning we do not need a prescription for an evaluation, but DO need a referral or script to perform any treatment. It’s better to have one at your initial evaluation, but we can help you attain a script from your provider after your initial evaluation, if needed. The referral or script can be from any practitioner authorized to prescribe treatment as outlined by the Texas Physical Therapy Practice Act. Such as a primary care physician (MD or DO), OBGYN, chiropractor, certified nurse midwife, physician assistant and nurse practitioner.
On your first visit we will collect quite a bit of information from you, so please bring any prior tests or diagnostics run such as colonoscopy’s, ultrasounds, MRI’s, Xrays, etc because we will review them and ask you questions. Then we will perform an examination within your comfort level. With the evaluation there will be some movement and testing involved, wearing comfortable clothing would be helpful.
Yes, if you cancel your appointment less than 24 hours before your appointment you will be subject to a cancellation fee of $50.