Summary of Privacy Practices (2 pages)
Patient Registration Form (3 pages)
Orthopedic Medical Questionnaire (2 pages)

Office Referrals

Many patients are referred by an emergency room or urgent care clinic for acute traumatic incidents, such as:

• Fractures
• Hand trauma
• Injuries to the joints

Some patients experience day-to-day problems, such as persistent pain to the joints, limbs, or muscles. After seeking the advice of the patient's regular physician (primary care physician), a patient may be referred to an orthopedic surgeon for further evaluation. This exam may reveal a medical condition that can be managed medically on a short-term or long-term basis and/or may require surgery.

It is important to remember that once evaluated by an orthopedic surgeon, a patient may require further testing, such as:

• Blood test
• X-ray
• Magnetic resonance imaging (MRI)
• Electromyography (EMG)

These tests will aid our physicians in better assessing your medical needs. Follow-up exams after testing are usually conducted in the office. We recommend that patients review their tests with their physician in person, since treatment is individualized.

Your First Office Visit

If at all possible, please print, review, and fill out the following forms prior to your arrival. This will prevent delays when you arrive at our office, and will make the registration process go more smoothly.

Summary of Privacy Practices (2 pages)
Patient Registration Form (3 pages)
Orthopedic Medical Questionnaire (2 pages)

If you are unable to print and complete these forms prior to your first office visit, please plan to arrive at our office 15 minutes before your scheduled appointment time. This will give you time to provide us with basic demographic information and complete your personal medical history without delaying your appointment.

At Every Office Visit

In an effort to avoid rescheduling, we request that you have available at each appointment:

• Insurance identification card
• Necessary referrals or authorization as mandated by your insurance company
• Any and all diagnostic studies related to your condition
• A complete list of medication, including dosages
• The name, address, and telephone number of your referral source and your primary care physician
• Co-payments

Rescheduling

Given the frequently urgent nature of an orthopedic practice, our surgeons may need to rearrange their office schedules from time to time. Although we prefer not to cancel any patient's appointment, our office staff may need to do so if the physician is called away to an emergency. Please provide our staff with an alternate telephone number in the event that an emergency rescheduling situation arises.

Cancellations

We look forward to caring for the orthopedic needs of your entire family. In an effort to better service all of our patients, we kindly request a 24-hour appointment cancellation notice.

Workers' Compensation

Our office does treat workers' compensation injuries. All treatment and surgeries must be authorized before they are performed. Workers' compensation contact information must be provided to our office prior to scheduling your appointment.

Self-Payment Policy

Payment is due for all services rendered in our offices; free care is only available in the hospital. If you do not have health insurance, our office billing staff will assist you by working out a payment plan tailored to your individual situation.