Get Seaview Orthopaedic Motor Vehicle New Patient Packet

Filling out the Seaview Orthopaedic Motor Vehicle New Patient Packet online is a straightforward process designed to ensure your information is accurately captured for your visit. This guide will walk you through each section of the packet, making it simple and user-friendly.

Follow the steps to complete the new patient packet efficiently.

1. Click the ‘Get Form’ button to obtain the packet and open it in the editor.
2. Begin with the 'Patient Information' section. Fill in your full name, address, city, state, zip code, date of birth, claim number, and date of injury. Ensure all information is accurate and legible.
3. In the 'No Fault Authorization for Health Information Disclosure' section, write the name of your insurance company and authorize Seaview to disclose necessary health information.
4. Complete the 'Patient Medical History Questionnaire.' Indicate the reason for your visit, how long you have been experiencing your current issues, and any methods you have tried for relief. Include your current medications and provide your pain rating on a scale from 0 to 10.
5. Review the 'Notice of Privacy Practices' and ensure you understand your rights regarding health information. Your acknowledgment of this document will be required later in the form.
6. Fill out the 'Communication Preference Form' to specify how you would like to be contacted regarding your care. List your preferred methods of communication.
7. Complete the 'Opioid Medication Agreement' if applicable, which involves acknowledging your agreement with the terms outlined regarding opioid use.
8. Review and sign the 'Financial Policy and Patient Agreement,' ensuring you understand your financial responsibilities.
9. Lastly, make sure all sections are complete. Save your changes, then download the completed packet. You can choose to print it for your visit or share it electronically.

Complete your Seaview Orthopaedic Motor Vehicle New Patient Packet online today for a smoother experience during your visit.