Schedule a New Patient Appointment | THE ARMORY | Columbus, Ohio Logo
  • THE ARMORY
  • Schedule a New Patient Appointment

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  • Demographic Information

    Please provide your basic personal information. Accurate details help us maintain your medical record and ensure all communication and documentation are correct.
  • By providing your phone number and submitting this form, you consent to receive SMS text messages from THE ARMORY. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out or HELP for more information. Consent is not a condition of purchase. See our Privacy Policy for details. 

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  • Insurance Information

    Although THE ARMORY does not bill insurance for any services, we require your insurance information for our records. This information may be used when coordinating prescriptions, obtaining prior authorizations, or referring you to outside providers such as labs, imaging centers, or specialists.
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  • Pharmacy and Laboratory Information

    Please provide your preferred pharmacy and laboratory information. This allows our team to coordinate prescriptions, prior authorizations, and lab testing efficiently. If you haven’t had recent labs drawn, we’ll generate an order for you and contact you once results are available to schedule your provider visit.
  • Current and Past Medical History

    Tell us about any current or past medical conditions, injuries, or surgeries. Sharing this helps us get a full picture of your health and provide the best care possible.
  • Exercise Physiology

  • Dietitian/Nutrition Consult

  • Physical Therapy New Patient Referral Form

  • Hi! Thank you for choosing THE ARMORY for your physical therapy needs.

    Please note that we do not accept insurance as a means of payment for physical therapy services rendered. All services must be paid for with cash or card at the time of service.

    Pricing is as follows:

    • SHIELD member - $100 per visit
    • STANDARD or Pro Fitness member - $160 per visit
    • Non-members - $200 per visit
  • Patient Acknowledgment


    By signing the form below, I acknowledge and agree to the following:

    1. I understand that payment is due at the time of service, and that no care will be provided until payment is received.
    2. I understand that providers at THE ARMORY are not credentialed with Medicare, Medicaid, or any commercial insurance company. All services are considered out-of-network and cannot be submitted to insurance for reimbursement.
    3. I understand that a $75 cancellation fee will be applied if I fail to provide at least 24 hours’ notice to reschedule or if I do not show for my appointment.
    4. I understand that I may use HSA or FSA funds for this service, and that an itemized invoice can be provided by the office upon request.
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