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FLORIDA Orthopedic INSTITUTE SPINE FIRST VISIT QUESTIONNAIRE Please circle answers to questions that pertain to your problem. You may select more than one answer per question. This information will

How to fill out florida orthopaedic institute spine

How to fill out Florida Orthopaedic Institute Spine:

1. Start by neatly completing your personal information section, including your name, date of birth, address, and contact information.
2. Indicate the reason for your visit or the specific condition you are seeking treatment for in the designated area.
3. If you have insurance coverage, provide the necessary details such as the insurance company's name, policy number, and any other required information.
4. In the medical history section, accurately document any previous surgeries, allergies, medications, or chronic conditions that may be relevant to your spine condition.
5. Be sure to provide a comprehensive list of all medications you are currently taking, including dosages and frequency.
6. If you have any specific concerns or questions related to your spine condition, make a note of them in the spaces provided.
7. Fill out any additional forms or questionnaires that may address specific aspects of your spine condition or treatment options.
8. Review the completed form for any errors or missing information before submitting it to the Florida Orthopaedic Institute.

Who needs Florida Orthopaedic Institute Spine:

1. Individuals who are experiencing back or neck pain, spinal deformities, or spinal injuries may require the services of the Florida Orthopaedic Institute Spine.
2. Patients who have been referred by their primary care physicians or other specialists for further evaluation and treatment of spine-related conditions.
3. Those who have exhausted conservative treatment options and are seeking expert guidance and surgical intervention to address their spine condition.
4. If individuals have been diagnosed with a spinal condition that requires ongoing care, including physical therapy, rehabilitation, pain management, or other specialized services, they may benefit from the expertise provided by the Florida Orthopaedic Institute Spine.
5. People looking for a multidisciplinary team approach, involving orthopaedic surgeons, neurosurgeons, physiatrists, and other healthcare professionals, to address complex spinal conditions may find the services of the Florida Orthopaedic Institute Spine valuable.

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