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Practice Name

SHP Rehab and Wellness Center

Social Media
Primary Location
Four Harvard Circle, Suite 700
West Palm Beach, FL 33409
Phone: (561) 684-9200
Fax: 561-684-9202

Office Hours

DayOpenClosed
Monday8:30am7pm
Tuesday8:30am6:30pm
Wednesday8:30am7pm
Thursday8:30am4pm
Friday8:30am7pm
SaturdayClosedClosed
SundayClosedClosed
Main Content

In order to provide you the best possible wellness care, please complete this form

Patient Data

Mailing Address

Current Complaints

Nature of Injury

Insurance Information

*If an auto accident, please provide:

Signature(s)

Name of the Insured _____________________________________________

I understand and agree that health/accident insurance policies are an arrangement between an insurance carrier and myself. I understand and agree that all services rendered to me and charged are my personal responsibility for timely payment. I understand that if I suspend or terminate my care/treatment, any fees for professional services rendered to me will be immediately due and payable.

Patient's signature _______________________________________________

Date ____________________

Spouse's or guardian's signature __________________________________

Date ____________________

Medical History

Have you ever:

Family History

Habits

Have you ever suffered from:

Sign up using the form or call (561) 684-9200 to make your appointment.

Name: *
Email: *
Phone: *

About SHP Rehab and Wellness Team Meet our friendly staff that will guide you on your visit here in our clinic. Make An Appointment We will do our best to accommodate your busy schedule. Schedule an appointment today! Online Forms Our patient forms are available online so they can be completed in the convenience of your own home or office.

Testimonial

Recently, I had the unfortunate experience of injuring my lower back when I pulled a stupid maneuver on my lawn mower. Details withheld. In any event, the next morning, I could not get out of bed alone, much less walk correctly. After a couple of days of therapy from Spinal Health Performance, I felt good as new. Thank you, guys!

Daniel B. / West Palm Beach, FL

Office Hours

DayOpenClosed
Monday8:30am7pm
Tuesday8:30am6:30pm
Wednesday8:30am7pm
Thursday8:30am4pm
Friday8:30am7pm
SaturdayClosedClosed
SundayClosedClosed

Contact

  • Four Harvard Circle, Suite 700 West Palm Beach, FL 33409
  • (561) 684-9200
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