Important Patient Information
What to bring to your first appointment:
Any Xray films or discs, MRI films or discs, or CT scans or any other tests that you have had
Any Xray, MRI or CT reports
Referrals for treatment if needed by your insurance
Your referring physician name and phone number
A list of all medications
Completed Registration Form
Completed Medical History
Completed HIPAA Privacy Notice
Completed Notice of Privacy Practices Form
Completed Patient Co-Pay Acknowledgment Form
Completed Patient Financial Policy
Completed Work Related Injury Form
Completed Medical Record and Medical Form Policy
Completed Completion Request Form
Completed Demographics Form
Please call our surgical coordinator, Erika Barragan, at 312 842-4600, Monday through Friday between 9AM and 5PM. If she is not available to take your call please leave a message including a phone number where you can be reached and she will promptly return your call.
We accept most major insurances. We can usually verify acceptance of your insurance at the time when you make your appointment.
After Hours Information:
Midland Orthopedic Associates offers 24 hour on call services for emergencies involving our patients. To contact the on call physician regarding your emergency call our office and you will be connected to an operator who can page the on call physician. Office appointments cannot be made and medications cannot be prescribed after hours. For life threatening emergencies go to your nearest emergency room or call 911.
Obtaining Medical Records:
Please contact the office where you are receiving your care for medical record questions.
- Wabash office: Contact Lucy Melendez at 312 842-4600
- Hometown office: Contact Jill Hannigan at 708 425-1150
- LaGrange office: Contact Jill Hannigan at 708 482-7767
Forms Completion Policy:
Forms will be completed within 10 business days after receipt. There is a $10.00 fee to complete each form. Please refer to our form policy at the time of your first visit.