Patient Info / Forms

Are you living with painful symptoms? At Back In Action Physical Therapy and Kappes Wellness Centers, our ultimate goal is to help you identify the root cause of your pain, and create a custom treatment program that will allow you to return to normal activities pain-free.

At our Ocean Pines, MD clinic, we are here to help you enjoy your life, because you deserve it.

If you’re ready to make an appointment, simply call us today at (410) 208-6705 or click here to request an appointment.

What your first visit with us will be like:

We strive to provide our patients with a warm, friendly, and welcoming environment at all times. Below is a list of what you can expect your first appointment with Back In Action Physical Therapy to be like.

  • You will register with our friendly front office staff upfront. They will help you with the insurance process and treatment program so you can focus on your recovery.
  • You will meet with your physical therapist for your initial evaluation.
  • During your evaluation, your physical therapist will ask questions about your medical history, current pain symptoms, or injury. Be as honest as you can; open communication helps us understand your problem better.
  • Your movement, strength, coordination, and more will be evaluated. Our purpose is to help you, so please ensure you communicate to your therapist if anything is hurting or bothering you during the examination. Our goal is always to have you leaving in less pain than you were in when you arrived.
  • Your therapist will recommend a treatment course and prepare a plan to ensure the best outcome and fastest recovery.
  • On your first day, there will most likely be some treatments performed to get you started on your road to recovery. However, during the next visit, you will get into the full swing of your treatment plan.
  • At the front desk, you will schedule your series of visits. The amount of therapy needed will be discussed with you, depending on the recommendations of your therapist. We offer many convenient appointment times, however, prime times can become busy! Try to book ahead as much as possible.
  • Your physical therapist will write up what they found during your examination, and create your customized treatment plan to submit to your referring physician or another medical professional of your choice.
  • If you have any questions at any time, please don’t hesitate to call us! We want to ensure your satisfaction and full recovery.

How to prepare for your first visit:

  • You should bring a copy of your insurance card and a photo ID with you.
  • Arrive 15 minutes early for your first appointment, as you will have paperwork to fill out.
  • Please call our office to verify your insurance benefits ahead of time.
  • If you have any questions, make a list of them to discuss on your first visit.
  • Any signs and symptoms you’re experiencing that can be of importance to the therapist are important to note down.
  • Have in writing key past medical history, previous treatments, current medications, and other important information.

Ready to get started? Fill out your new patient forms beforehand!

If you would like to save time on your first visit, please print the following patient documents below. Fill them out and bring them with you to your first appointment.

1 Office Policies

New Patient Form & Questionnaire

2 Office Policies

Office Policies

3 Office Policies

Health Insurance Form

4 Office Policies

HIPAA Authorization Form

If you don’t have time to print them off before your appointment, no worries! Simply allow around 15 minutes of extra time before your appointment to fill them out in our clinic. At Back In Action Physical Therapy, we are here to help you get the most out of your visit – contact us today!



8:00 am - 5:30 pm




8:00 am - 5:30 pm


8:00 am - 5:30 pm


9:00 am - 12:00 pm






Please do not submit any Protected Health Information (PHI).