Physical Therapy

We have received many requests from our therapy groups to create printable forms for staff members to print and share with therapists to pre-fill before starting the authorization request in the Cohere platform. 

The questions in these documents are for reference only. PLEASE DO NOT FAX ANY OF THESE FORMSThese questions are designed to capture key information about the patient's specific clinical situation based on the diagnosis and services requested for approval. Answering these clinical assessment questions increases our ability to issue an auto-approval, which ultimately saves you time.

*Note that these questions are subject to change at any time without notice.*

 

See the table below for individual forms separated by body site and care path.

*Last updated: December 23, 2021*

Body Site

Diagnosis and Link

*Click to access*

 Hip
 Knee
 Spine
 Shoulder
 Foot
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