New patient checklist
Below is a checklist of items and forms that will help prepare you for your upcoming appointment and make your visit as productive as possible. (If records or test results are being sent to Twin Cities Spine Center by other facilities, all information should be sent in advance of your appointment to our main office location in Minneapolis, regardless of the clinic location of your appointment.)
- Medical records. If your relevant records are not already at our clinic, please obtain them and bring them with you.
- Previous x-rays, CT or MRI scans. Actual films or CD is required. Reports alone are not sufficient.
- Results of previous testing or treatment (EMGs, physical therapy, etc.).
- Bring any corsets, braces or other supports prescribed for you.
- Registration form— complete, print, sign and bring with you.
- Health history intake form - print, complete and bring with you.
- Patient financial policy - for review.
- Financial disclosure—for review.
- Notice of HIPAA privacy—for review.
- Patient consent form—print, complete and bring with you.
- Assignment of benefits form - print, complete and bring with you.
- Verbal authorization form - if you want to give us authorization to discuss your health information with individuals you designate (spouse, family member, friend, etc.)
- You will be sent via U.S. mail two questionnaires, which must be filled out with a No. 2 pencil. Please complete those forms and bring them with you.
- Information for patients booklet—for your review.
- Maps and directions to our various clinic locations.
For your first visit, please plan to arrive 15 minutes early to get registered and plan on a two-hour period of time. At times, emergency situations necessitate extended time requirements. We apologize in advance for delays these demands could make on your scheduled appointment time.