(or if you haven’t been seen by us in 3 or more years).
During your first visit we want to know all about you. If you have had any tests, x-rays, or other information, be sure to bring them with you. Please fill out the Comprehensive Patient Questionnaire and Patient Registration Form, then print and bring them to your appointment.
(with demographic changes and/or if you haven’t been seen by us within the last year).
If any patient information has changed since your last visit (i.e. insurance carrier, address, etc.) please update us by completing a new patient registration form to print and bring to your next appointment. If you haven’t been seen by us within the last year please also complete the Patient Questionnaire Update form.
There is a $25 charge for each Disability or Family Medical Leave Act (FMLA) form we complete on your behalf. These forms may be required by an employer, home or auto loan, or any other facility that requires disability information. Allow up to five business days to process your request. Please complete and return to the office the Release of Information form below which will be necessary to complete your request.
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Southwest Shoulder Elbow & Hand Center PC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.