Patient Forms

Patient Forms

For your convenience we have provided the downloadable forms all new patients are required to complete. If you find this convenient, please print each form and complete prior to your first visit to STRIVE Physical Therapy.

Forms to bring to your first visit:
New Patient Forms

Forms to retain for your own records:
Notice of Protected Health Information Practices

200,000 +
Patients Seen
265 +
Team Members
4000 +
Physicians Refer Patients To Us

Contact Us


5479 Pottsville Pike
Suite 200
Leesport, PA 195335


(610) 926-6778


(610) 926-7200

Convenient Hours

  • Monday - Thursday 7:00 AM - 8:00 PM
  • Friday 7:00 AM - 4:00 PM
  • Saturday 8:00 AM - 12:00 PM
Request An Appointment

Our Awards

Strive has been voted as The Best or One of the Best Physical Therapy Providers in Southern New Jersey every year since 2011, as one of the best places to work, and as one of America's fastest growing companies.