(207) 657-5600 office@grayptcenter.com

Forms & Insurance

New Patient Forms

New patients can save time during their first visit by completing and submitting the following forms online. Simply click on the form’s title to submit the requested information. Please note that all information submitted via these forms will be kept confidential as befits the nature of the contents.

Click on the button below to download the form. Please complete the form and then upload it to us using the form on this page.

New patients should plan to arrive 15 minutes early for their first appointment.
If you have a lengthy medication list, please bring it with you and we will make a copy.
  • Max. file size: 128 MB.

Injury Specific Questionnaires

Click onto the appropriate link for your problem and fill out the questionnaire to the best of your ability. Follow the directions & share your score to office@grayptcenter.com.

205 Portland Rd
PO Box 1047, Gray, Maine 04039

Tel: (207) 657-5600
Fax: (855)-464-0106

office@grayptcenter.com

Founding Members of:
Proudly Serving The Following Communities:
Gray, New Gloucester, Raymond, Cumberland, North Yarmouth, Pownal

Our Affiliate:
Premier Physical Therapy
316 Portland Rd

Bridgton, Maine 04009

Tel: (207) 647-2727

205 Portland Rd
PO Box 1047, Gray, Maine 04039

Tel: (207) 657-5600
Fax: (855)-464-0106
office@grayptcenter.com

Our Affiliate:
Premier Physical Therapy
316 Portland Rd

Bridgton, Maine 04009

Tel: (207) 647-2727

Founding Members of:

Proudly Serving The Following Communities:
Gray, New Gloucester, Raymond, Cumberland, North Yarmouth, Pownal