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THRIVE

PHYSICAL THERAPY & WELLNESS

New patient? Click here!

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New Patient Inquiry Form

Please complete & submit the following form if interested in making a new patient appointment.

First & Last Name

Email

Phone

DOB

Do you have BCBS insurance?

If pregnant, what is your due date? If you recently had a baby, what date did you deliver? Was it vaginal or c-section?

How did you hear about us?

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Thrive Physical Therapy and Wellness | Birmingham, AL | (205) 312-7925

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