Patient Information Forms  



For your convenience, our Medical History Form, Medical Release Form, and Physical Therapy Prescription Form, are available to download to your computer by clicking the buttons below. You may print out the forms and complete them prior to your scheduled appointment with us. Please either fax the completed forms to us at (410) 747-5202 or bring them in when you arrive for your scheduled visit. In addition, be sure to have a signed physical therapy referral or consultation form from your referring doctor for your first visit.


Esterson & Associates Physical Therapy

Two West Rolling Crossroads
Suite 100-102
Baltimore, MD 21228
Phone  (410) 747-1600
Fax       (410) 747-5202



Monday -  Thursday        8:00 am - 8:00 pm

Friday                                 8:00 am - 4:00 pm
Saturday                           Closed
Sunday                              Closed

  • Facebook App Icon
  • Instagram

© 2015 Esterson PT