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FORMS AND POLICIES

• GENERAL FAQ

• ORTHOPAEDIC FAQ

• TESTS & DIAGNOSTICS

• FORMS & POLICIES

Select the appropriate form or policy and print before your first appointment.

To print, select the form or policy and click the "Send to Printer" button.

FORMS

• Authorize FoxCare Orthopaedics to Disclose Health Information
  (Gives permission for FoxCare Orthopaedics to release your health information to another provider)

• Authorize Outside Provider to Release Health Information to FoxCare Orthopaedics
  (Gives permission to an outside provider to release your health information to FoxCare Orthopaedics)

• Health Insurance Portability and Accountability Act (HIPAA) Notice and Acknowledgement
  (This notice provides an explanation of how FoxCare Orthopaedics may disclose you private health information.  Please review the form prior to your first appointment. Sign the Notice of Acknowledgment and bring it to your appointment)

• New Patient Medical History
  (Please complete the medical history form and bring it with you to your first appointment with a list of all medications that you are currently taking)

POLICIES

• Payment Policy
  (Contains information regarding our payment and insurance coverage policies)

• Emergency Policy
   

• Prescription Refill Policy
   

• Telephone Message Policy
   

• Office Policy for Disability, Worker's Compensation and Other Forms
  (Please read prior to completing appropriate form)