Forms & Payment

Accepts new patients

Medicare	Medicaid	Workers' compensation	Other

Office information from Jan V T Bear, MD

A. Patient Instructions
Instructions for completing our office forms.

B. Medical History, page 1
Please complete this form prior to coming to the office.

C. Medical History, page 2
Please complete this form prior to coming to the office.

D. OANNM Billing Information Worksheet
Please complete this form prior to visiting our office.

E. HIPAA Policy Part 1
OANNM HIPAA Policy

F. HIPAA Policy Part 2
OANNM HIPAA Policy

G. Patient Rights and Responsibilities
The expectations of OANNM in regards to Patient Rights and Responsibilities.

Contact Information

Orthopaedics & Sports Medicine of Santa Fe 1631 Hospital Drive Suite 200 Santa Fe, NM USA 87505 View map Phone 505-424-0200 Fax 505-424-6608

Other staff in my practice

Dr. Sann Gossum
Dr. Samuel Chun
Dr. Corey Lieber
Mr. Sean Wilson, PA-C
Ms. Angie Cline, PA-C
Mr. Richard Cook, PA-C

This site has been viewed 1,518 times.

This website is provided by the American Academy of Orthopaedic Surgeons as a service to its members. All materials on this Web site have been created, developed or assembled by the member physician, who is solely responsible for its content and any permissions necessary to properly place the materials on this website. The Academy does not review this information nor does it exercise editorial control over it.