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Please fill out this Workers Compensation Form to the best of your ability. 

This will ensure a faster appointment with us since we can enter your information into your medical chart before you come, obtain any necessary medical records well in advance of your office visit and verify your insurance is active.

The safety and security of your information is very important to us and we use the highest levels of security measures to ensure that we are HIPAA compliant.

If you prefer you may print out the PDF Workers Compensation Form and bring the completed form with you at the time of your office visit.

At Southland Orthopaedics Ltd., We look forward to taking care of you.