SIGN THE FORM BELOW

Thank you for helping us in our efforts to remain in Aetna’s provider network. Our aim is to continue providing excellent physical therapy care for Aetna members across the state. Please fill out the form below and press “submit” to add your name to the appeal. You may also provide a written testimonial about your experience with PTSMC.

We appreciate your help and we thank you for choosing PTSMC as your physical therapy provider!

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Request Appointment

Request An Appointment

If you would like to schedule an appointment at a PTSMC or PT For Life clinic, please submit your information below. A Patient Service Coordinator will contact you at your earliest convenience to find a time that works best for you!

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