The Therapy Center for Physical Rehabilitation and Wellness, LLC
225-638-4455 p 225-208-6173 f
New Patient Forms
If you would like to speak to a staff member before completing forms, we understand. Call or click here to leave your contact information and we will call you within the business day if possible to answer any questions.
Print and Fill Option: Print and Fill the following and fax to 225-208-6173