Our clinic partners with employers, claims professionals, and legal teams to provide timely, outcomes-focused care for patients with Workers’ Compensation and Personal Injury claims. To ensure efficient scheduling and care coordination, please review the documentation and referral guidelines below.
Required Documentation
To avoid delays in scheduling and authorization, the following documentation is required at the time of referral
- Patient demographic information
- Full legal name
- Date of birth
- Phone number and email
- Address
- Full legal name
- Date of injury
- Clearly documented injury date
- Mechanism of injury (if available)
- Clearly documented injury date
- Claim information
- Claim number
- Insurance carrier or WC administrator
- Type of claim (Workers’ Compensation or Personal Injury)
- Claim number
- Medical records
- Last three relevant appointment or office visit notes
- Pertinent imaging reports (if available)
- Prior treatment history related to the injury
- Last three relevant appointment or office visit notes
Incomplete documentation may delay patient contact or scheduling.