Patients

Forms

Please view and fill out the forms below prior to your visit. You have the option of printing then completing the forms by hand or filling them out digitally and printing the completed forms. We appreciate your time to prepare for your appointment.

Patient Registration Form

Medical Release Form

Workers Compensation Form


Insurance Information

List of Participating Insurance Providers 

Information for Uninsured Patients


 

Workers Compensation

There are special reporting requirements that must be met to guarantee that the benefits due under workers’ compensation programs are received.

Patients must provide the following:

• Completed Patient Registration Form and Workers Compensation Form.

• Social Security Number.

• Compensation insurance carrier, claim number, contact name, contact phone number(s) and fax number.

• Employer name, HR contact person and phone number.

• Date of injury information and a copy of the first report of injury document.
The document may be faxed by your employer to us at 540-722-4514.

We will provide copies of reports to one party from whom other related parties may obtain their copies.
Unless instructed otherwise, we will assume this is the insurance carrier.


Educational/Informational Brochures

ACL Injuries Presentation

Arthroscopy of Acute Shoulder Dislocation Presentation

Commotio Cordis Presentation

STOP-Sports Injuries Presentation  

What’s New

  • AOSSM In Motion E-Newsletter Winter 2017

    The quarterly American Orthopedic Society for Sports Medicine In-Motion newsletter is now available, this quarter’s featured articles are: | Don’t Let an Avalanche of Injuries Curtail Your Cross Country Skiing | Proper Warm-up May Help Prevent Fencing Injuries | The Dangers of Extreme Weight-Cutting | Skin Infections in Wrestling | You can click here to […]

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  • AOSSM In Motion E-Newsletter Fall 2017

    The quarterly American Orthopedic Society for Sports Medicine In-Motion newsletter is now available, this quarter’s featured articles are: | What You Need to Know about Shoulder Instability and Bracing | SLAP TEARS 101 | Shoulder Replacement Does Not Mean Goodbye to Sports | Don’t Call the Tooth Fairy on the Field | You can click here […]

    Read more...

  • AOSSM In Motion E-Newsletter Summer 2017

    The quarterly American Orthopedic Society for Sports Medicine In-Motion newsletter is now available, this quarter’s featured articles are: | The Magic of Stem Cells | Freezing Your Injuries with Cryotherapy—Good or Bad? | Patella Instability: When should surgery be considered? | Return to Play after ACL Reconstruction | You can click here to read/download it now.

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  • AOSSM In Motion E-Newsletter Winter 2017

    The quarterly American Orthopedic Society for Sports Medicine In-Motion newsletter is now available, this quarter’s featured articles are: | New Treatment for ACL Repair | Stress Fractures in Basketball | Are PRP injections a magic wand for fixing athletes? | Keep Rowing Injuries at Bay | You can click here to read/download it now.

    Read more...