Background: Vital signs including body temperature, blood pressure, heart rate, respiratory rate, and pulse oximetry are components of the clinical decision making process by physical therapists. Vital signs help to predict physical therapy indications, contraindications and outcomes. Previous studies have shown that physical therapists do not always objectively measure vital signs each visit. Objectives: The purpose of the study was to examine the clinical decision making process involved in the measurement of vital signs by physical therapists. Design: This study was a qualitative design utilizing a questionnaire with three sections including demographic data, clinical decision making questions, and two risk-based scenarios in which participants were asked to indicate whether or not they would assess vital signs. Methods: Seventeen practicing physical therapists were given a questionnaire by phone, email, or in person. Data were recorded, coded, and transcribed. Answers to open ended questions were grouped into themes based on common responses and similar characteristics. Results: The primary factors cited in response to source of reference for cardiovascular risk included clinical experience, education, and patient presentation. The primary factors provided in response to the decision to treat or refer based on abnormal vital signs included patient history, clinical experience, various parameters, and contacting the physician. Conclusion: The variation of factors that influenced the decision making process by the participants may be reflective of the lack of guidelines and the broad understanding of the need and benefit of objectively assessing vital signs.