The following forms are provided for your convenience so you can fill out the information prior to arriving for your appointment. Please make sure you call, (703) 849-8808, and schedule your appointment first.
Please download the necessary forms here, by clicking on each form name:
- Patient Registration Form
- Patient Photography & Video Release
- HIPAA Consent Form
- HIPAA Authorization Form
- HIPAA Privacy Form
- Financial Policy Fee For Service
If you have any questions or comments, please feel free to call our office or submit your comments by clicking here.
GENERAL APPOINTMENTS AND X-RAY CHECKLIST FOR SCOLIOSIS BRACING
____ Casting/Scanning for Brace (1 hour)
____ Delivery/Fitting of Brace (2 hours)
____ 1-2 weeks after wearing the brace full-time have an in-brace x-ray (may be done concurrently with follow-up if using the EOS Center)
____ 1st follow-up appointment to discuss in-brace x-ray and make any necessary adjustments
____ 6 months after brace delivery have an out-of-brace x-ray. Generally do not wear brace for 24 hours prior to this appointment (EOS Center)
____ 2nd follow-up appointment to discuss out-of-brace x-ray and make any necessary adjustments (can be combined with X-Ray if using the EOS center)
____ 1 year from brace delivery, have 3rd follow-up and out-of-brace x-ray. Generally do not wear brace for 24 hours prior to this appointment (EOS Center).
An appointment with your referring practitioner should also be made.
____ At this point if significant growth has been achieved by patient or if significant curve changes have occurred, a new brace may be prescribed.
NOTE: Timelines of x-ray appointments may vary according to your referring doctor.