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NEW PATIENT INTAKE FORMS

We are excited for your first appointment with us and we look forward to helping you!
Please download and fill out the appropriate form by clicking on the button(s) below:

Please arrive to our office 20 minutes before your appointment with the forms filled out as completely as possible. You will also need to bring:

1. The Physical Therapy Referral / Rx from your doctor
2. Photo ID (example: Driver’s license)
3. All Insurance Cards
4. List of all current medications and vitamins including dosage, frequency, and administration route.

Feel free to call us if you have any questions or need help with directions: 949-465-9500.

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LOCATION & CONTACT INFO

23832 Rockfield Blvd., Ste. 160

Lake Forest, CA 92630

info@balancerehab.net

Phone: 949-465-9500

Fax: 949-465-9506
 

 © 2025 Balance Rehabilitation Inc.

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OFFICE HOURS

Monday:       7am to 7pm 

Tuesday:       7am to 7pm 

Wednesday: 7am to 7pm

Thursday:     7am to 7pm

Friday:           7am to 2pm

Saturday:      Closed 

Sunday:         Closed

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