Institute for sacroiliac treatment, research, and education
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Out-of-State Physical Therapy Patients
Out-of-State New Patient Packet

NOTICE OF PRIVACY PRACTICES

If you are coming from out-of-town and are planning on being treated at the Hesch Institute, please complete our Out-of-State New Patient Packet and forward it as soon as possible before scheduling your first visit. 

You may find a printable, or online-fillable version, at the buttons at the bottom of the page 
(including privacy, fees & financial forms). 
We accept all major Credit Cards, Check, and HSA/FSA Cards. We don't bill medical insurance companies, but will provide you with a detailed invoice, so you can file a claim with your insurance provider.

Please remember to write a narrative outlining a description of your symptoms and past treatment.

If you have MRI's, CT Scan, X-Ray's please provide the reports.


Upon request we can schedule a follow-up phone call or video (Skype, Zoom, Facetime) at any time after treatment, ideally 1-2 weeks after your last visit. We can also have you send a video of you performing the self-treatment and home exercise program. One option is to upload it on You Tube as a private link and forward the link. Of course you can contact us at anytime.  

               



 Below is a recommended hotel/AirBnB  
 If you have questions or need help with the link, please do not hesitate to ask. We appreciate your business and look forward to working with you in the future.
Airbnb; https://abnb.me/gtqDiMxsfvb  (10 mins south of Hesch Institute)
Fairfield Inn & Suites Denver Aurora/Parker (in an open mall), with plenty of shops and restaurants.
Click for best rates; Hesch Institute 
Springhill Suites by Marriott - Parker, Co. (20 mins south of Hesch Institute)
Click for link;  www.marriott.com/hotels/travel/denpk-springhill-suites-denver-parker

                                  Denver International Airport is 20 mins north of Hesch Institute.
                     If you wish to be closer to airport do online search. There are many hotels close to airport.

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        Please put your name on each page, as we receive multiple faxes daily
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Below either choose: Option 1- to print New Patient Forms for either email or fax.
                                 
Option 1 - Click below to download print version the New Patient Form Packet           including privacy & financial forms) to either fax or email, or US Mail to Hesch
Institute. Please don't send us photos inside email, we prefer a PDF attachment if sending by email.
Location/Travel information
Intake Form - Printable Version
Intake Form - Online Version