Identification and Insurance Information
- Current photo ID
- Current insurance card(s)
- Insurance co-payment, co-insurance and/or deductible information, if applicable
- Insurance referral, if applicable*
* Please verify that our office has received the referral prior to your appointment. Having a copy of your insurance referral is recommended.
Medical Information for Current Injury or Condition
All medical records, imaging (X-ray, MRI), and lab test results for your current injury or condition should be carried in or faxed from your primary care provider. If you have been evaluated or treated for your current injury or condition by another healthcare provider, please contact their office at least one week prior to your appointment, if possible, to request a copy of all medical records pertaining to your injury or condition. You can request that your records be sent directly to our office, but please confirm that we have received them prior to your appointment.
Personal Documentation of Current Injury or Condition
Throughout your visit, you will be asked questions about the injury or condition that you are being seen for. You may find that compiling a personal documentation record prior to your visit and bringing the record with you to your appointment may assist you in answering some of these questions. Please note that the information in your personal document will not be used as a substitute for any official forms you will be asked to complete prior to your appointment.
Here is some sample information that you may want to include in your personal injury or condition documentation …
- Date of injury or onset of condition
- Precise location of injury or condition
- Activity you were doing prior to or during the onset of the injury or condition
- Documentation of other medical treatment you received with regard to this injury or condition
- Home remedy treatments you have tried
- Description of pain
The following words are helpful in properly diagnosing the cause of your pain:
Note the time(s) of day that your pain is usually at its worst, and rate your pain on a scale of 0 – 10.
(0=No Pain and 10=Unbearable Pain)
Note the time(s) of day that your pain is usually at its least, and rate your pain on a scale of 0 – 10.
(0=No Pain and 10=Unbearable Pain)
Rate your level of pain on a scale of 0 – 10 when you do one or more of the following activities:
- Laying down
- Bending over
Note any other activities you do that make you feel better or worse.
Note any side effects or symptoms you are having caused by your injury or condition.
The following are examples of common side effects caused by pain:
- Loss of appetite
- Difficulty concentrating
Current List of All Medications
Bring a current list of all your medications, including the name of the medication, dosage, the frequency you take the medication, and the reason for the medication. This list should include prescribed medications, herbal supplements, vitamins, and over-the-counter medications you are taking as well as any medications you are allergic to. We recommend having this record with you as you may need to access this information during your appointment.
Maintenance of your medical history, including all prior treatments, surgeries, conditions and illnesses, even if they are not related to your current injury or condition, is always recommended. Bring this record with you as you may need to access this information during your appointment.
List of Questions and Concerns to Address During Your Appointment
We recommend that you compile a written list of all the questions and concerns that you want to address during your time in our office. There will be several departments and individuals that you will come into contact with during your visit. To assist you in compiling your list of questions and concerns, we have provided you a list of the departments/services for you to begin your list:
- Appointment Scheduling
- Front Desk Reception
- Billing and Insurance
- Radiology (X-Ray, MRI Technicians)
- Nurses/Medical Assistants
- Physician Assistant(s)
- Physical Therapy
- Checkout Reception
- Surgery Scheduling
Notepad and Pen/Pencil for Notes
Take notes on what the office staff and medical staff discuss with you. Be sure to ask questions if you do not understand a policy, procedure, medical term, or the reason for your doctor’s diagnosis, treatment plan, recommendations, medication instructions, or post-appointment instructions. If you need additional information to take with you, ask your doctor for handouts, brochures, or online resources that you can review at home.
Emergency Contact Information
An emergency contact list is a document you should have ready and keep updated regularly. Having this list with you at your appointment may provide you information you need in completing the required paperwork.
A Family Member or Friend
You may consider asking another adult to accompany you to your appointment. Should you need a translator, please bring an adult translator with you or contact our office prior to your scheduled appointment to make arrangements. We do not recommend that you rely on a child to translate.