Orthopedic Patient Information | Everett Bone and Joint

425-339-2433

Everett Bone & Joint signage

PATIENT FORMS

Patient Registration

To be completed by all new patients.

Health History

To be completed by all new patients.

Medical Questionaire

To be completed by existing patients returning with the same injury.

Incident Report

To be completed by existing patients returning with the same injury.

needed

You have decided to make an appointment with an orthopedic specialists. Some insurance companies require a referral before you schedule an appointment. Please check with you primary care physician or your insurance carrier.

Call 425.339.2433 to schedule your appointment. We have a knowledgeable staff that can help you determine if our office is contracted with you insurance carrier

WHAT TO BRING TO YOUR OFFICE VISIT:

Insurance identification card.
Payment for your insurance co-pay. This must be paid at your first visit. We accept cash, check and credit cards.
Your referral - if required.
Previous x-rays; MRI's and/or reports.
A complete list of ALL medications.