Forms

For New Patients

Please print and complete this form and bring it with you to your first appointment.

Locations

7 Specialty Care Locations

1Middlesex Health Physical Rehabilitation - Outpatient Center, Saybrook Road, Middletown

534 Saybrook Road
Middletown, CT 06457
Office Hours
Mon
7:00 AM - 6:00 PM
Tue
7:00 AM - 6:00 PM
Wed
7:00 AM - 6:00 PM
Thu
7:00 AM - 6:00 PM
Fri
8:00 AM - 2:00 PM
860-358-2700
Fax
860-358-2727
Middlesex Health Physical Rehabilitation - Outpatient Center, Saybrook Road, Middletown

2Middlesex Health Physical Rehabilitation Center - Essex

252 Westbrook Road
Essex, CT 06426
Office Hours
Mon
7:00 AM - 6:00 PM
Tue
7:00 AM - 6:00 PM
Wed
7:00 AM - 6:00 PM
Thu
7:00 AM - 6:00 PM
Fri
7:00 AM - 2:30 PM
860-358-2700
Fax
860-358-2727
Middlesex Health Physical Rehabilitation Center - Essex

3Middlesex Health Physical Rehabilitation Center - Madison

1347 Boston Post Road
Madison, CT 06443
Office Hours
Mon
8:00 AM - 6:00 PM
Tue
8:00 AM - 6:00 PM
Wed
7:00 AM - 6:00 PM
Thu
8:00 AM - 6:00 PM
Fri
7:00 AM - 12:00 PM
860-358-2700
Fax
860-358-2727
Middlesex Health Physical Rehabilitation Center - Madison

4Middlesex Health Physical Rehabilitation Center - Marlborough

6 Independence Drive, Suite 1
Marlborough, CT 06447
Office Hours

Patient care and rehabilitation services are delivered by a team of experienced, licensed professionals — including physical and occupational therapists, and speech-language pathologists.

Mon
7:00 AM - 6:00 PM
Tue
7:00 AM - 6:00 PM
Wed
7:00 AM - 6:00 PM
Thu
7:00 AM - 6:00 PM
Fri
7:00 AM - 11:30 AM
860-358-2700
Middlesex Health Physical Rehabilitation Center - Marlborough

5Middlesex Health Physical Rehabilitation Center - Middlesex Hospital Campus

28 Crescent Street
Middletown, CT 06457
860-358-2700
Middlesex Health Physical Rehabilitation Center - Middlesex Hospital Campus

6Middlesex Health Physical Rehabilitation Center - North Campus, Middletown

512 Saybrook Road
Middletown, CT 06457
Office Hours
Mon
7:00 AM - 6:30 PM
Tue
7:00 AM - 6:30 PM
Wed
7:00 AM - 6:30 PM
Thu
7:00 AM - 6:30 PM
Fri
7:00 AM - 5:30 PM
860-358-2700
Fax
860-358-2727
Middlesex Health Physical Rehabilitation Center - North Campus, Middletown

7Middlesex Health Physical Rehabilitation Center - Portland

13 High Street
Suite 2
Portland, CT 06480
Office Hours
Mon
8:30 AM - 6:00 PM
Tue
8:30 AM - 1:30 PM
Wed
8:30 AM - 6:00 PM
Thu
8:30 AM - 1:30 PM
Fri
8:30 AM - 2:00 PM
860-358-2700
Middlesex Health Physical Rehabilitation Center - Portland