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Patient information

All you need to know on how to be a part of the Blue Rose Community

Patient Forms

Download Forms
You may print and complete our patient forms prior to your initial evaluation. You may email or fax the completed form(s) to:
BRoffice@bluerosephysicaltherapy.com
Bringing our North Little Rock based physical therapy services to you

Mobile Concierge Services

With our Mobile Concierge Service, you will choose where we provide exceptional individualized one-on-one care to best meet your needs and schedule.
Contact us to set up a perfect time and location for you!
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Accepted Insurance

Blue Rose Physical Therapy:

Provider Select
Bringing our North Little Rock based physical therapy services to you

Mobile Concierge Services

With our Mobile Concierge Service, you will choose where we provide exceptional individualized one-on-one care to best meet your needs and schedule.
Contact us to set up a perfect time and location for you!
You may print and complete our patient forms prior to your initial evaluation. You may email or fax the completed form(s) to:
BRoffice@bluerosephysicaltherapy.com
1-866-724-7887
View Patient Forms
Patient Information
Insurance Information Past Medical History
Medication List
Consent to Treat
HIPAA Privacy Acknowledgement
Release of Information
Cancellation and No-Show Policy
Accepted Insurance

Blue Rose Physical Therapy:

Provider Select
Private Healthcare Systems (PHCS)
American Care Source
Amerigroup
CorVel Corporation
Coventry
Employer’s Health Choice PPO
Fortified Provider Network
FedMed
Galaxy Health Network
Heartland Therapy Provider Network
Municipal Benefits Health Fund
Health Link of AR
Prime Health Services
Centene/NovaSys/
Ambetter
QualChoice of Arkansas
Rockport Healthcare Group, Inc.
Three Rivers Provider Network
USA Managed Care Organization
Vantage Health Plan
Windsor Health Plan/Wellcare
WellMed of Arkansas (aka Physicians Health Choice)
AETNA
ArkBCBS
  • Arkansas Blue Cross and Blue Shield Preferred Payment Plan
  • USAble Corporation Arkansas’ FirstSource PPO
  • USAble Corporation True Blue PPO
  • USAble Corporation Primary Care Network
  • HMO Partners, Inc (d/b/a Health Advantage)
Tricare* Certified
Medicare
Medicaid* Over 21
*Please call to check if we take your insurance and other options available that can reduce your costs*

Benefits of Concierge, Cash-Based, and Out of Network Care Health Care Model

Our goal is to make this process as easy as possible for you. If you have any questions along the way make sure to reach out to us. We’re just a phone call away.
Direct Personalized Care
Our mobile concierge cash-based service is completely individualized, personalized, and private. Because cash based modeling removes significant overhead and time that comes with billing insurances, our experienced Physical Therapists will be able to provide the best, personalized one-one-one care possible.
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Increased Access to the Clinician
Not only do you receive direct and personalized one-on-one care in a location of your choosing, but you also have increased access to our Physical Therapists for any questions, concerns, or need of additional interventions. You will have direct access to our Physical Therapists via email, phone, or text with our Cash-Based and mobile concierge services. Blue Rose Physical Therapy is truly at your Service!
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Flexibility
You don’t have to worry about spending time or the money to travel to us! Our mobile concierge service allows you to not miss a beat in your life and we can come to you to your preferred appointment times. Don’t shy away from physical therapy because of inconvenience. Receiving quality therapy has never been easier!
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By-pass Restrictions and Red-Tape
Our Physical Therapists are not restricted by insurance companies and physician referrals are not required. We can treat the person as a whole not just the condition. There is no limitation on our services in time, frequency, or interventions provided, which allows our therapist more freedom to meet your needs and passions. This all-inclusive approach allows the best and truly personalized care that is invaluable to your overall happiness, health, and success.
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Cost-Effectiveness
High insurance premiums, co-pays, deductibles, and out pocket expenses continue to be the norm in the United States placing unnecessary financial strain to individuals requiring healthcare services. Typically, clients receiving brick-and-mortar Physical Therapy attend 3 times per week for 8 weeks with co-pays averaging between $30 to $50 per visit. That accumulates up to $150 per week and $1,200 for total care provided. During these visits, the therapist is often dividing his or her time and attention between multiple clients, which you MAY receive 15 minutes of total direct care. That’s a large sum of money for non-direct care. If clients choose to receive cash-based services, they would receive undivided personalized one-on-one care 100% of the time once per week for $100-120 per visit. And due to this direct care, results usually occur faster requiring less visits. At 8 visits, the person would spend up to $960 per visit. That is a savings of $240 with more direct and personalized care! Better care, more convenience, quicker results all for less money; it’s a no-brainer!
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