Forms & Payment

Accepts new patients

Medicare Medicaid Workers' compensation Other
Yes No Yes Yes

Medical insurance plans and payment options

Bennett Orthopedics & Sportsmedicine Accepts: Almost all Private Insurance Plans Personal Injury Auto Accidents Worker's Compensation

Payment Plan acceptable for cash paying patients

Office information from William F Bennett, MD

J.) HIPPA POLICY
Full HIPPA Policy

A.) New Patient_Shoulder_Medicare
These forms can be filled out when opened on the internet site. You can then save the document to your computer with the information that youentered. Following, you can email "attach" the saved document to bennettorthopedics2@verizon.net for an appointment. This way you can keep a copy on your computer. As an alternative, there is a email "icon" that will be able to send the form with its new information directly to our office, if you have "outlook" on your computer and have an "outlook" email account set up.Please "cc" to bennettorthopedics1@verizon.net and bennettorthopedics@verizon.net, Thanks and look forward to seeing you.

B.) New Patient Non_Shoulder_Medicare
These forms can be filled out when opened on the internet site. You can then save the document to your computer with the information that youentered. Following, you can email "attach" the saved document to bennettorthopedics2@verizon.net for an appointment. This way you can keep a copy on your computer. As an alternative, there is a email "icon" that will be able to send the form with its new information directly to our office, if you have "outlook" on your computer and have an "outlook" email account set up.Please "cc" to bennettorthopedics1@verizon.net and bennettorthopedics@verizon.net, Thanks and look forward to seeing you.

C.) New Patient Shoulder Private Insurance/Work Comp/Cash
These forms can be filled out when opened on the internet site. You can then save the document to your computer with the information that youentered. Following, you can email "attach" the saved document to bennettorthopedics2@verizon.net for an appointment. This way you can keep a copy on your computer. As an alternative, there is a email "icon" that will be able to send the form with its new information directly to our office, if you have "outlook" on your computer and have an "outlook" email account set up.Please "cc" to bennettorthopedics1@verizon.net and bennettorthopedics@verizon.net, Thanks and look forward to seeing you.

D.) New Patient Non_Shoulder Private Insurance/Work Comp/Cash
These forms can be filled out when opened on the internet site. You can then save the document to your computer with the information that youentered. Following, you can email "attach" the saved document to bennettorthopedics2@verizon.net for an appointment. This way you can keep a copy on your computer. As an alternative, there is a email "icon" that will be able to send the form with its new information directly to our office, if you have "outlook" on your computer and have an "outlook" email account set up.Please "cc" to bennettorthopedics1@verizon.net and bennettorthopedics@verizon.net, Thanks and look forward to seeing you.

E.) New Patient Shoulder_Auto/Personal_Injury
These forms can be filled out when opened on the internet site. You can then save the document to your computer with the information that youentered. Following, you can email "attach" the saved document to bennettorthopedics2@verizon.net for an appointment. This way you can keep a copy on your computer. As an alternative, there is a email "icon" that will be able to send the form with its new information directly to our office, if you have "outlook" on your computer and have an "outlook" email account set up.Please "cc" to bennettorthopedics1@verizon.net and bennettorthopedics@verizon.net, Thanks and look forward to seeing you. You will need your attorney to sign the Letter of protection and acknowledge the Assignment of Benefits document.

F.) New Patient Non_Shoulder_Auto/Personal_Injury
These forms can be filled out when opened on the internet site. You can then save the document to your computer with the information that youentered. Following, you can email "attach" the saved document to bennettorthopedics2@verizon.net for an appointment. This way you can keep a copy on your computer. As an alternative, there is a email "icon" that will be able to send the form with its new information directly to our office, if you have "outlook" on your computer and have an "outlook" email account set up.Please "cc" to bennettorthopedics1@verizon.net and bennettorthopedics@verizon.net, Thanks and look forward to seeing you. You will need your attorney to sign the letter of protection and teh assignment of benefits form.

G.) Employment Application (Non-Clinical)
Employment application for non-clinical positions.

H.) Employment Application (Clinical)
Employment application for clinical positions.

I.) Definition of Usual Customary and Reasonable Fees
Definition of the term usual Customary and reasonable fees.

Contact Information

Bennett Orthopedics & Sportsmedicine 1250 S. Tamiami Tr Suite 303 Sarasota, Fl USA 34239 View map Phone 941-953-5509 Fax 941-953-5510

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Other staff in my practice

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