HIPAA. This is given to you on your visit. You can print this out, however this is for your records and reference. You will be asked to sign saying you received a copy of this information.
"Confidential Patient Health Record" form.
Work Comp Incident Form
Please read and sign all paperwork before your appointment.
* PLEASE NOTE ... if you cannot print and complete paperwork in advance, YOU MUST ARRIVE 30 MINUTES PRIOR TO YOUR SCHEDULED APPOINTMENT OR YOU WILL NEED TO BE RESCHEDULED. Thanks for your cooperation.
Report your injury to your supervisor and make sure that a written report is filed!
Speak with your human resources work comp rep
Some companies have specific steps to be followed before you seek chiropractic care (ie. you may need to see the on-site company doctor)
Be sure to get: claim #, claim's address, a fax number for claims, claim adjuster's name & direct phone #
Arrive at your appointment on time with:
If you are late for your new patient appointment or do not have your paperwork, we may need to reschedule you so as not to inconvenience other patients on the schedule.
We thank you for your understanding of this policy.
* PLEASE NOTE ... PAPERWORK MUST BE COMPLETED BEFORE YOUR APPOINTMENT!
If you cannot print and complete paperwork in advance, YOU MUST ARRIVE 30 MINUTES PRIOR TO YOUR SCHEDULED APPOINTMENT OR YOU WILL NEED TO BE RESCHEDULED. Thanks for your cooperation.