954-383-5474  

 
 

to google map of this location5975 North Federal Highway
2nd Floor
Ft. Lauderdale, Florida 33308

 
 

 

 

 

Patient Forms

 
Please download and complete the following packet of forms prior to your admission.

7 page packet includes:

(1) Patient Information (2 pages)
(2) History of Current Episode (1 page)
(3) Authorization/Consent/Financial Policy (1 page)
(4) HIPAA Compliance (2 pages)
(5) Medical Records Release (1 page)

Patient Fees

Appointments:

Appointments are available from 8:00am to 5:00pm Monday through Friday. Appointments may be scheduled at (954) 383-5474 or email at drmaryanntowne@aol.com. Allow 15-20 minutes prior to your initial visit to fill out your admission forms or download them and complete them prior to your first visit. Shorts and/or workout attire will provide modesty and comfort during your evaluation.

Please note a $175 cancellation fee will be charged for no shows and/or cancellations without 24 hours notice.

Fees:

Initial Evaluation Fee $250.00
Treatment Fee $175.00
Infant Torticollis Evaluation Fee $50.00
Infant Torticollis Treatment Fee $50.00
Discharge HEP Fee $50.00
Records Review Fee (per 15 min) $50.00
Taping Fee $15.00
Personal Electrodes $10.00/per pack

**Please note Dr. Towne utilizes a flat-fee for services rendered
(NOT insurance reimbursable).**


Please call (954) 383-5474 or email drmaryanntowne@aol.com for further information.

towne physical therapy centre
E-mail:
drmaryanntowne@aol.com

Fax: (954) 491-1927

 

 

 

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