Appointment Preparation Checklist

PSC Appointment Checklist

 

  • Completed patient forms

  • Valid form of identification

  • List of all your medications

  • Insurance card

  • Insurance Referral (if required)

  • Payment (cash, check, Visa, Mastercard, Discover or American Express)

  • Phone and fax numbers for your referring doctors and primary care physician

  • MRI or x-ray films and all other records related to your injury or condition

Appointment Preparation Information

  • Please arrive 30 minutes prior to your appointment. Failure to bring your MRI and/or x-ray films and any records related to your spine/orthopedic injury or condition may require rescheduling your appointment.

  • Please remember to list all your prescription and nonprescription medications (including herbal or alternative), plus the dosage.

  • If your insurance requires a referral from your primary care physician, we must receive this before your scheduled appointment.

  • Co-pays, and/or all other amounts not covered by your insurance must be paid at the time of your appointment; deductibles are collected prior to surgery (if surgery is needed). If you are a “Self-Pay” patient, please be prepared to make full payment or your appointment will be re-scheduled. We accept cash, check, Visa, MasterCard, Discover and American Express.

  • All FMLA/Employer and Disability Insurance forms are subject to a $35 processing fee and must be paid before receipt. Please leave forms at the front desk and allow seven to 10 business days for completion.

  • If you need to cancel your appointment, please do so within 24 hours of your appointment. No-shows will be charged a fee of $25.

  • In order to respect the time of each and every one of our patients, your appointment will be rescheduled if you are over 15 minutes late for your appointment.

PIPER SPINE CARE

P: (636) 229-5900

F: (636) 229-5011

112 Piper Hill Drive
Suite 6
Saint Peters, MO 63376, USA

©2019 by Piper Spine Care