HomepageOur Mission and Core ValuesServices at Seneca Physical TherapyFitness and Nutrition Articles
Seneca Wellness & Fitness Center  Nutritional Counseling Massage Therapy
FAQ

15201 Shady Grove Rd. Suite #106
Rockville, MD 20850
Tel: 301-948-4395
Fax: 301-840-8972

Downloadable Forms for New Patients

Testimonials

Clinical Staff at Seneca Physical Therapy

 
 Wellness Center Forms and Fees

If you are a scheduled for an initial appointment, you can get a head-start and save time by downloading the following forms. These are downloadable in either PDF or DOC format.

PDF format
(requires Adobe Acrobat Reader)

Wellness Center Health Questionnaire
Credit Card Authorization form

Request for Termination
Request for Hold

Doc format
(faster download)
Wellness Center Health Questionnaire
Credit Card Authorization form

Request for Termination
Request for Hold

 


Initiation Fee

Current patients of Seneca receive Option One for $25.00.
Former patients of Seneca receive Option One for $50.00

Non-patients have two options:

Option One: 
   $100.00 which includes basic information regarding exercise and medical history, heart rate, and blood pressure plus three personal training sessions.

Option Two:    $150.00 which includes basic information regarding exercise and medical history, heart rate, and blood pressure plus three personal training sessions and body fat, flexibility, and strength measurements.

Monthly Fees
  • $60.00
  • $57.00 for senior citizen 65 years or older 
  • 5% discount for monthly fees when a credit card authorization form is used.

    NO LONG-TERM CONTRACTS REQUIRED

Extras  

  • Personal fitness training sessions @ $40.00 for each 30 minute session or $70.00 for each 60 minute session.
  • Specialized personal fitness training with a physical therapist @ $50.00 for each 30 minute session or $90.00 for each 60 minute session.
  • Body Composition Measurement @ $30.00

 


Home l About Us l Services l Staff l FAQ l Contact l Privacy l Testimonial
Wellness Center l Health Screening l Nutrition l Massage

Copyright © 2000-2003, Seneca Physical Therapy Inc.   All rights reserved. 
The information contained in this web site is not a substitute for medical advice or treatment,
and Seneca Physical Therapy recommends you consult with your doctor or health care professional.

Website hosted by 270net.com
Health screening registration system developed and maintained by 270net.com