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Thank you for making your appointment with Lake Orthopaedic Associates, Inc.

Please verify with your Insurance Company that we are on your plan.

To help us accommodate your needs, we have made a checklist for you. Please bring the following to your appointment.

  • The Downloadable forms, provided in advance to make your appointment more carefree. Fill in and Print from your computer OR print out and Fill in by hand.
  • Your insurance card(s) along with your co pay which is due at time of visit
  • Referral if necessary
  • Drivers license or photo ID
  • Any tests you have had regarding your problem for example EMG or lab results
  • Any X-ray files including MRI, C. T. scan, etc along with the reports
  • Any other information that may help our physician(s)
  • For Workers Compensation Patients:
    • B.W.C. Card with your MCO information
    • C-9 if needed
    • Employer information - Name and phone number of contact person

Please hand carry all this information with you to your appointment. Do not mail.

Patients who are not covered by health insurance will be required to pay for services as they are rendered. Payment arrangements can be made.

If the patient is under age of 18 years, a parent/guardian must accompany the patient. If the parent/guardian can not be present, a note of permission must be presented with the patient before they can be treated.

We accept cash, check, Discover, Master Card and Visa.

If you are unable to bring all of the information listed above, please call so that we may reschedule your appointment.

Please let us know if we can assist you in any way.

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New Problem Form
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Health History Form AND Current Medications/Drug Allergies
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