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INTAKE FORMS
Save time and fill out the intake paperwork

Click one of the buttons to the left to view the form (scroll up if viewing on a mobile device with a narrow screen). Fill in the information and print, then either mail it back to us or bring it with you to your first appointment.

Synergy Physical Therapy participates with these insurance plans:

  • Blue Cross Blue Shield
  • Tufts
  • Cigna/ASH
  • Harvard Pilgrim
  • Medicare
  • United Health Care
  • Unicare/GIC State Indemnity
  • Health New England
  • Boston Medical Center Health Net Plan

If you don’t see your insurance listed above please call us at 413-727-3315.

Co-payments are expected at the time of service unless prior arrangements have been made. Synergy Physical Therapy accepts Visa, Mastercard, American Express, Discover, Medical Flexible Spending Account, Health Equity Accounts, checks, and cash.

Depending upon your agreement with your insurance company, you may be responsible for some or all of your bill (ie: deductible and/or co-insurance). Synergy Physical Therapy will do their best to provide you with information about your insurance coverage however, don’t hesitate to call your insurance company with specific questions.

Self-Pay

For those patients who have exhausted their insurance benefits or don’t have coverage for physical therapy, Synergy offers a self-pay option. We can also offer this option for out-of-network patients as well as patients with high deductibles. Please call our office for the self-pay rates at 413 727 3315.

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