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Referral Form Fax Number: (570) 4217091 Appointment Line: (570) 4217020www.mountainvalleyortho.com Patient: Please call our office at (570) 4217020 to schedule your appointment with one of our orthopedic
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Gather all necessary information about the patient such as personal details, medical history, current medications, allergies, and any previous surgeries or procedures.
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Go through each question on the existing patient medical form and fill out the information accurately.
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If there are any questions that you are unsure about, it is recommended to consult with the patient or their healthcare provider for clarification.
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Who needs existing patient medical questions?

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Healthcare providers such as doctors, nurses, and medical assistants who are responsible for managing and treating the patient's health.
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Health insurance companies may also require existing patient medical questions to assess a patient's health condition and determine coverage eligibility.
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Research institutions and clinical trials may use existing patient medical questions to gather data and study specific health conditions.
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Existing patient medical questions are a set of inquiries related to a patient's current health status, medical history, and any ongoing treatments or medications.
Healthcare providers or medical facilities are typically required to file existing patient medical questions as part of the patient's record or for insurance purposes.
Existing patient medical questions can be filled out by providing accurate and detailed information about the patient's health condition, history, and any treatments they are currently undergoing.
The purpose of existing patient medical questions is to gather comprehensive information about a patient's medical background and current health status to ensure appropriate care and treatment.
Information such as medical history, current health conditions, medications being taken, allergies, and any ongoing treatments must be reported on existing patient medical questions.
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