Patient Forms / Insurance

Patient Forms

At Power Physical Therapy and Sports Medicine, we want to maximize your time with us. Prior to your first visit, please print and fill out the new patient forms below. Please bring these with you to your first visit along with your insurance information and photo ID.



We are contracted with most major insurances. Below is a sample list of many of the insurances we work with, but it is not exhaustive. We are regularly updating and expanding our network, so please call us at Costa Mesa, CA center if you have any questions regarding your particular insurance.

  • Aetna
  • American PPO
  • Blue Cross
  • Beech Street
  • Blue Shield
  • Cigna
  • Galaxy Health Network
  • Healthsmart
  • Integrated Health Plan
  • Medicare
  • National Preferred Provider Network
  • Rockport
  • Three Rivers Provider Network
  • TriCare
  • Union Pacific RR
  • United Healthcare
  • Workers’ Comp.
  • Memorial Care Medical Foundation

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