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  • External link opens in new tab or window510 547-8293
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  • External link opens in new tab or window6300 Telegraph Avenue, Oakland, CA 94609
  • External link opens in new tab or windowFax Number: 510 547-2102
SPORTS & ORTHOPEDIC SPECIALISTS
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REGISTRATION



REGISTRATION FORMS


WE DO NOT OFFER ONLINE REGISTRATION

A registration packet will be mailed to you which includes your registration forms and information about the clinic.

Please bring the registration packet and completed forms with you for your first visit.

Please fill out all of the forms before you come in as this will save you time.

You may also download the registration forms below, fill them out and bring them with you on your first visit.




REGISTRATION FORMS FOR PRIVATE INSURANCE AND AUTO INSURANCE


COMMERCIAL & AUTO INSURANCE REGISTRATION FORM
COMMERCIAL INSURANCE BILLING & PAYMENT POLICY
APPOINTMENT POLICY
YOUR PLAN OF CARE
HEALTH QUESTIONNAIRE
PATIENT INFORMATION CONSENT FORM
AUTO BENEFIT FORM

 


REGISTRATION FORMS FOR CASH PAYMENT PATIENTS


PATIENT INTAKE FORM
APPOINTMENT POLICY
YOUR PLAN OF CARE
HEALTH QUESTIONNAIRE
PATIENT INFORMATION CONSENT FORM


REGISTRATION FORMS FOR MEDICARE PATIENTS


You may continue to receive physical therapy treatment above the

threshold amount if your PHYSICAL THERAPIST determines that your therapy is MEDICALLY  NECESSARY.

Medicare considers treatment to be medically necessary ONLY when a patient is showing SIGNIFICANT PROGRESS in a REASONABLE AMOUNT OF TIME.

Medicare does not pay for therapy that maintains a patient at their current level of pain or dysfunction. There must be documentable progress.

The exception is for patients diagnosed with a degenerative neuromuscular disease.


MEDICARE REGISTRATION FORM
MEDICARE ADVANTAGE PLAN REGISTRATION FORM
MEDICARE BENEFIT INFORMATION
APPOINTMENT POLICY
YOUR PLAN OF CARE
HEALTH QUESTIONNAIRE
PATIENT INFORMATION CONSENT FORM

 



PRIVACY:

Your Information. Your Rights. Our Responsibilities.

SOS HIPPA PRIVACY POLICY

  • PATIENT RESOURCES
  • FAQ
  • SOS FUN FACTS
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