Patient Intake Forms

New patients are welcome to fill out required paperwork below and bring in on your first visit and begin your Physical Therapy Evaluation / Treatment right away!

All forms are in Adobe PDF format.  If you need to download the Adobe Acrobat plugin,

please click here.

Local: (352) 562-7772   Toll Free: 1-877-658-1433 

Divine Therapy & Wellness, LLC.

Divine Therapy & Wellness, LLC.

3300 SW 34th Ave.

Suite 124B

Ocala, FL 34474

Toll Free: 1-877-658-1433

Fax: (321) 400-1422


(352) 562-7772

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Monday -  Friday     7:00 am - 5:00 pm
Saturday                   Closed
Sunday                      Closed


Schedule Appointments:

Monday - Saturday 7am - 8pm

Our Hours:


© 2013 Divine Therapy & Wellness, LLC. All rights reserved.