Scope of Services
Describe assessment, therapy modalities, frequency, maximum sessions, goals, and any exclusions. Specify whether telehealth is permitted, and list responsibilities for home exercise programs, equipment, and progress reporting.
Using a Professional Physical Therapist Agreement establishes clear expectations, reduces billing and consent disputes, documents informed consent and HIPAA obligations, and creates enforceable terms for scope, payment, and termination. It protects both practitioner and patient by formalizing responsibilities and risk allocation.
Licensed therapists, outpatient clinics, hospital therapy departments, rehabilitation centers, and independent contractors use the Professional Physical Therapist Agreement.
Use this agreement when engaging patients for regular therapy services, contract placements, or third-party billing arrangements.
Oversees adoption and enforcement of patient agreements, confirms therapist licensure and malpractice insurance, attaches HIPAA addenda, and coordinates billing and documentation. The administrator tracks renewals, ensures versions are current, and maintains executed copies for compliance and audit readiness.
Signs as service provider or contractor, documents scope, fees, cancellation policies, and confidentiality; must retain proof of consent and copies of signed agreements. Independent practitioners should verify governing law and obtain client signatures before starting treatment.
Describe assessment, therapy modalities, frequency, maximum sessions, goals, and any exclusions. Specify whether telehealth is permitted, and list responsibilities for home exercise programs, equipment, and progress reporting.
State fee schedule, billing party, accepted payment methods, insurance billing responsibilities, co-pay and deductible expectations, cancellation and late fee policies, and timing for invoicing and collections.
Document informed consent for treatment, capture privacy notices, include HIPAA authorization if PHI is shared, and describe data handling, storage, and patient rights to access records.
Limit liability where allowed by law, disclose malpractice insurance coverage, clarify indemnification obligations for third-party claims, and address limits on consequential damages to the extent permitted.
Detail termination for convenience, for cause, notice periods, refunds or pro-rated charges, and obligations that survive termination such as confidentiality and payment.
Specify the governing state law and forum for disputes; note that ESIGN and UETA affect electronic execution and choice-of-law may change enforcement outcomes.
All terms drafted and reviewed by stakeholders.
Internal approvals and payer checks completed.
Signatures obtained; date fields completed.
Store executed copy; apply retention schedule.
Supply a completed W-9 to payers when requested.
Payers file 1099-NEC when contractor payments meet thresholds.
Keep I-9s per federal requirements after hire.
Retain HIPAA-related records for six years (45 CFR §164.530(j)).
Keep executed agreements for at least three years post-termination.
| Workflow Field Description and Configuration | Recommended setting or value for each field |
|---|---|
| Signer Authentication Method and Strength | Email + SMS code; upgrade to KBA if required |
| Form Field Types and Conditional Behavior | Signature, initials, date, checkbox, conditional fields |
| Audit Trail Settings and Retention | Capture IP, timestamp, email, and action history |
| Storage and Export Format Settings | Save PDF/A with embedded audit certificate |
Platform integrations and file formats affect how you share and sign Professional Physical Therapist Agreements.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | Yes, 7-day trial | No | No | Yes, limited | Yes, limited |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |
| Envelope Cap | No envelope cap | 100 envelopes/user/year | Varies | Varies | Varies |