Scheduling Terms, Cancellation, Payment, and Communications

Graves Performance Therapy, PLLC Effective date: September 1, 2026

This form is for private cash-based physical therapy or performance training with Dr. Ben Graves, PT, DPT, CSCS, BRM. It is not insurance registration.

Under Texas Direct Access (Tex. Occ. Code §453.301), treatment without a physician referral is limited to 30 consecutive calendar days. A referral from a referring practitioner is required to continue treatment beyond that limit. Patients receive the Board-required Direct Access disclosure before treatment without referral. Athletic performance training is not physical therapy and is not medical treatment.

Do not use this form to send medical history, pain details, imaging results, medication lists, or emergency concerns. If this is an emergency, call 911 or go to the nearest emergency room.

Submitting the form does not reserve a final appointment. The visit is confirmed only when Ben replies with a time and place.

Payment is due at the visit unless we agree otherwise in writing. - Evaluation or initial session (PT or performance): $150 (60 minutes) - Treatment or training session (PT or performance): $150 (60 minutes) - San Angelo visits: $20 travel fee Bundled visit packages are available; specifics are discussed with Ben directly. You are responsible for your own green fees, cart, or driving-range bucket. Private physical therapy may be by Texas Direct Access (up to 30 consecutive calendar days without a physician referral) or by physician referral. Either way, private visits are cash-based. This practice does not bill insurance for services provided. After a cash physical therapy visit, you may request an itemized superbill to submit to your health plan, HSA, or FSA for possible out-of-network reimbursement. This practice does not contact payers on your behalf and cannot guarantee coverage or payment. Superbills apply to physical therapy visits only — not sports performance training.

Payment is due at the visit unless we agree otherwise in writing. A no-show, or a cancel within 1 hour of the session, may be charged 50% of the visit or session cost, due before the next session.

If you check the box on the form, you allow Graves Performance Therapy, PLLC to email and text the number and address you provide only about: - appointment confirmation - reschedule or cancellation - meeting location and directions - payment-at-visit reminders This is not consent for marketing, newsletters, or social-media features. Message and data rates may apply. You can opt out of texts by replying STOP, and opt out of scheduling emails by telling us in writing. Opting out may make it harder to confirm a visit.

Physical therapy and sports performance training do not guarantee a specific clinical, performance, or athletic result. Individual responses vary. Evaluation findings, a plan of care, or a training plan are created after we see you in person. Nothing on this website is a promise of outcome.

Submitting a scheduling request is not consent to physical therapy or performance training. Informed consent is obtained in person (or as otherwise permitted by law) before services are provided. If the person receiving physical therapy or sports performance training is a minor (under 18 years of age in Texas) or otherwise lacks legal capacity to consent, a parent, legal guardian, or other person authorized under Texas law must authorize the services before they are rendered. Graves Performance Therapy, PLLC may decline or postpone services until that authorization is obtained. The adult accompanying a minor is responsible for remaining available as reasonably required for the visit.

This public website is not a medical-record system and is not attached to the clinical chart. Protected health information, personal information collected for care, and visit history are stored in a HIPAA-compliant electronic health record or other HIPAA-compliant method that is separate from this website. Scheduling contact information submitted here is used only to arrange a visit. Clinical records are created after the visit and kept as required by professional and legal standards.

The Notice of Privacy Practices is at /privacy and is part of these terms.