Forms & Payment
Accepts new patients
| Medicare | Medicaid | Workers' compensation | Other |
|---|---|---|---|
Medical insurance plans and payment options
Coventry, Blue Cross/ Blue Shield, Medicare
Cash, American Express,Visa, Mastercard, Discover
(For financial assistnce we suggest you investigate Care Credit (see link to carecredit.com on side bar), a service of GE Financial that is really user friendly and hassle free)
Office information from Dolf R Ichtertz, MD
CMC Arthroplasty Outcome Questionnaire CTS Questionnaire Hand DiagramUse the hand diagram to indicate the location of sensations. Mark the areas on the drawing with the symbol that best describes the sensation that you feel.
New Patient Letter Patient Information page 1 Patient Information page 2 Pre-Operative Clearance Form Shoulder Outcome Questionnaire Spanish Shoulder Outcome Questionnaire TarsalTunnelOutcomeQuestionnaire Tennis Elbow Outcome Questionnaire Vocational Symptom Relationship Checklist
www.nhsi@carpaltunnelrelief.net
Carol, Lisa and Chris work hard to ensure that your records are prepared promptly and accurately
I am pleased to introduce you to my highly trained and eager treatment team that makes everything possible. Lisa works the front desk, will collect your office visit payment and schedule your appointment. Carol N. will assist you with billing concerns. Dena, our nurse, assists with wound and cast care. She also coordinates consultations with other physicians and schedules surgery. Dena also first assists in surgery. Katie, our electrodiagnostic technician performs comprehensive nerve tests and quantitative senory exams under my direct supervision. Together, we are committed to providing the best possible orthopaedic care to our rapidly growing patient family.