Patient understanding of physiotherapy service flow is essential for adherence and outcomes. This study analyzes factors associated with patients' understanding based on Minister of Health Regulation No. 65/2015 at BLU Timikan Hospital. A cross-sectional study was conducted among 158 outpatients selected by consecutive sampling at BLU Timikan Hospital from January to March 2025. Data were collected using observation sheets, a validated questionnaire (Cronbach's alpha = 0.87), and medical records. Bivariate analysis employed chi-square tests, and multivariate analysis used logistic regression to calculate adjusted odds ratios (AOR) with 95\% confidence intervals (CI), controlling for age and education. Complete implementation was lowest for periodic evaluation (41.8%) and discharge planning (36.7%). Overall, 45.8% of patients demonstrated good understanding, with the poorest comprehension observed for informed consent (27.8%) and follow-up plans (25.3%). Bivariate analysis showed that incomplete flow implementation (chi^2 = 7.34, p = 0.007, phi = 0.215), verbal-only education (chi^2 = 10.82, p = 0.001, phi = 0.262), and lack of family support (chi^2 = 8.71, p = 0.003, phi = 0.235) were significantly associated with poor understanding, whereas waiting time was not (p = 0.218). After controlling for age and education, incomplete flow implementation (AOR = 2.84; 95% CI: 1.42-5.68; p = 0.003) and verbal-only education (AOR = 2.93; 95% CI: 1.44-5.96; p = 0.003) remained independently associated with poor understanding. The model demonstrated adequate fit (Hosmer Lemeshow p = 0.612).