Forms to Fill Out

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current medical insurance information and picture identification. We would be happy to assist you on the day of your appointment if you have any questions.

HMO Patients
If you have an insurance plan that is an HMO you are responsible for contacting your Primary Care Physician and obtaining an authorization/referral for your appointment with us. Please call us 1 to 2 business days prior to your appointment to confirm that we do have the authorization/referral.

Auto or Worker’s Compensation Patients
If you have an open claim with a worker’s compensation or auto adjustor we will need a letter to be faxed, mailed or you may bring it in with you stating the claim is open. This letter should also include the claim number, date of injury, insurance carrier name and mailing address, the claim adjustor name and telephone number. It is the patient’s responsibility to make sure we have this information at the time of the appointment.