PATIENT FORMS

Thank you for choosing ShimSpine for your orthopaedic and spine care needs.

NEW PATIENT PAPERWORK

This can be filled out on your computer or tablet and printed (PDF Reader is required). Alternatively, you can email your completed paperwork to the office. If you are unable to complete this on your electronic device, you may print it out and complete by hand.

Completing this paperwork ahead of time will help expedite your appointment and will also allow you to maximize your time with the physician. If you would like assistance in completing any part of this, please inform our office staff upon your arrival.

Please bring this paperwork along with your PHOTO ID and any INSURANCE CARDS & CLAIM INFORMATION to your appointment. Also please bring along all IMAGING STUDIES (X-ray films, MRI films) and REPORTS with you.

We recommend that you arrive at least 10 minutes prior to your scheduled appointment time if you have completed all of the above paperwork ahead of time. If you are unable to print out the New Patient Paperwork, please arrive at our office at least 20 minutes prior to your scheduled appointment.

Please select (click on) the appropriate paperwork packet to complete:

We make every effort to be on-time for your scheduled appointment and while emergencies do occur, we request that you notify our office ahead of time if you are going to be late. In some cases, we may need to reschedule your appointment.

DISCLOSURE STATEMENT

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.

Last modified: December 16, 2016