Office Forms and Letters

Preauthorization Form word
Referral Pads to Other Doctors
Protocol for Discharging a Patient
Letters to Notify Patients and Other Physicians of Doctor Leaving a Practice
Form for Verification of Patient’s Insurance Coverage
Inventory Control and Ordering Form
Orthotic Policy Waiver
Annual Patient Satisfaction Survey
DME Receipt
Computer Usage Acknowledgement
Computer Usage Policy
Code of Conduct
Complaint Protocol Policy
Complaint Resolution Form
Consent for Treatment Diabetic Patient
Contrast Therapy
Diabetes Feet edited by Gayle
Diabetic Foot Evaluation Form
Dictation Standards - Therapeutic Shoes
DM Shoe Paperwork
New Patients Forms
Excuse From Work Form
Fax Transmission Sheet for Diabetic Shoes
Financial Policy
General Consent
Guidelines Diabetic Ulcers
Ingrown Nail Consent Form
Initial Encounter and New Patient Insurance Form
INS Verification GS
Insurance Verification
Instructions for use and warranty for Therapeutic Shoes
Insurance Verification Form
Legal Assignemtn of Benefits and Release of Medical and Plan Documents
Medical Necessity
Medically necessary Appeal Form
Notice of Exclusion from Medicare
Nursing Home Intro Letter
Off Work Form
Office Policies Regarding Managed Care Insurance Plans
Orthotic Waiver
Painful Nail Sheet
Patient Payment due if Present without a Referral
Patients Present without a Co-Pay
Patinet Registration Form 2004
Patient Satisfaction Survey
Payment Authorization of Shoes
Plantar Fasciitis Techniques
Preauthorization Form
Return Policy for Therapeutic Shoes
Shoe Order Form
Standing Order Wound Care
Standing Order Nail Avulsion
Statement of Certifying Physician
Super Bill for Therapeutic Shoes and Insoles
VPT
Wound Care

In order to view or print some of these forms you will need Adobe Acrobat Reader installed. Click here to download it.

Optimism is the one quality more associated with success and happiness than any other. -Brian Tracy-