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    • Back Pain & Sciatica
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    • Rotator Cuff Injury
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    • ACL Injury
    • Elbow Wrist & Hand Pain
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Home » Patient Information » Patient Info / Forms

Patient Info / Forms

We are here to help you enjoy your life, pain-free! To make a convenient appointment or free consult or free consult, simply call us today at Wasilla: (907) 373-9462 or Anchorage: (907) 332-0021. Empower Physical Therapy is dedicated to helping you identify the cause of your pain and creating a custom treatment program that will allow you to return to normal activities pain-free.

Patient Forms

At Empower Physical Therapy, we want to maximize your time with us. 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 or free consult or free consult. Otherwise, allow extra time before your appointment or free consult or free consult to fill them out here.

  • 1

    MGA Release of Information

    Download & Print
  • 2

    New Patient Packet

    Download & Print
  • 3

    Pelvic Health New Patient Packet

    Download & Print
  • 4

    Pelvic Health FAQ

    Download & Print
  • 5

    Bladder Diary

    Download & Print

Before Your First Visit

  • Make a list of questions that you have to discuss on your first visit.
  • List signs and symptoms that can be of importance to the therapist.
  • Have in writing key past medical history, previous treatments, current medications, and other important information.
  • Please call our office to verify your insurance benefits.
  • Arrive 15 minutes early for your first appointment or free consult or free consult.
  • Bring with you a copy of your insurance card and a photo ID.

What to Expect on Your First Visit

  • You will register with our friendly front office staff, who will show you the clinic, bathrooms, coffee machine, and water cooler. The front office will help you navigate the insurance process and treatment program so you can focus on your recovery.
  • You will meet with our physical therapist for the initial evaluation.
  • During the evaluation, your physical therapist will ask questions about your medical history, current pain, or injury. Open communication helps us understand your problem.
  • Your movement, strength, coordination, and much more will be evaluated. Our purpose is to help you, so please ensure you communicate with your physical therapist if anything is hurting or bothering you during the examination.
  • Your physical therapist will recommend and prepare a course of treatments to ensure the quickest recovery and the best results. Your physical therapist will discuss the recommendations with you.
  • There will be some treatments performed the first day 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.
  • You will schedule your series of visits with the front desk. The amount of therapy needed will be discussed with you, depending on the recommendations of your therapist. We offer many convenient appointment or free consult or free consult times, however, prime times can become busy, so it is best to book ahead your entire treatment plan if at all possible.
  • Your therapist will write up their findings and treatment plan to submit to your referring physician or another medical professional who you choose.
  • If you have any questions at any time, please do not hesitate to call. We want to ensure your satisfaction and full recovery.
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Empower Physical Therapy - Wasilla

3190 East Meridian Park Loop
Suite 206 A

Wasilla, AK 99654

P: (907) 373-9462

F: (907) 373-9464

E: bbrendle@empoweralaska.com

Empower Physical Therapy - Anchorage

4361 Boniface Pkwy
Suite 3

Anchorage, AK 99504

P: (907) 332-0021

F: (907) 373-9464

E: bbrendle@empoweralaska.com

What We Treat

  • Arthritis
  • Sports Injury
  • Back Pain & Sciatica
  • Neck Pain
  • Headaches
  • Shoulder Pain
  • Rotator Cuff Injury
  • Hip and Knee Pain
  • ACL Injury
  • Elbow Wrist & Hand Pain
  • Foot and Ankle Pain
  • Balance & Gait Disorders
  • Dizziness & Vertigo
  • Chronic Pain
  • Fibromyalgia
  • Motor Vehicle Accident Injuries
  • Neurological Disorders
  • Pre/Post-Natal Pain
  • Pre-Surgical Rehab
  • Post-Surgical Rehab
  • Pediatric Sports Injury
  • TMJ Dysfunction
  • Women’s Health
  • Work Injury
  • View More Conditions

Health Tips

  • Health Blog
  • Newsletters

How We Treat

  • ACL Prevention
  • Dry Needling
  • Ergonomics
  • Graston Technique
  • IASTM
  • Kinesio Taping
  • Manual Therapy
  • Mulligan’s Concept
  • Myofasical Release
  • Regenerative Rehab
  • Therapeutic Exercise
  • Traction
  • Ultrasound
  • Vestibular Therapy

About

  • Our Practice
  • Our Locations
  • Our Team
  • Join Our Team

Patient Info

  • Patient Info / Forms
  • Insurance Info
  • Patient Testimonials
  • Refer a Friend
  • FAQs
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We are currently open and operating normally.

Our staff is taking extra steps to ensure the cleanliness of the clinic space.  You may notice some changes that we have implemented to protect our patients and staff. Currently, we are encouraging patients to stay home if you are not feeling well.  Otherwise, we are here and ready to see you for your appointments. If you have any questions about your appointments, please reach out to us. We are following the recommendations of the CDC. It is very important for our patients to understand that you need to get your information from reliable sources.  We do NOT recommend that you trust any information posted on social media. This includes re-posts of articles. Always seek out information directly from the source. We have compiled a list of reliable sources of information about the coronavirus for you.
Coronavirus Resources:
  • CDC page about Coronavirus
  • Coronavirus Fact Sheet
  • What to do if you are sick 
  • Stop the spread of germs
  • Symptoms of coronavirus
Sincerely, Empower Physical Therapy