EBJ Proliance Surgeons (A.K.A Everett Bone & Joint)
Orthopedic Patient Appointment
 

Make An Appointment

Call 425.339.2433 to schedule your appointment.

You have decided to make an appointment with an orthopedic specialist. Some insurance companies require a referral before you schedule an appointment. Please check with your primary care physician or your insurance carrier.

What To Bring To Your Office Visit:

  • Insurance identification card.
  • Payment for your insurance co-pay. This must be paid at your first visit. We accept cash, check and credit cards.
  • Your referral – if required.
  • Previous x-rays; MRI’s and/or reports.
  • A complete list of ALL medications.

Patient Forms

Patient Registration

PLEASE FILL OUT, PRINT, AND BRING TO YOUR APPOINTMENT.

To be completed by all new patients.

Patient Contact

Authorization To Leave Personal Health Information By Alternative Means.

Authorization For Disclosure of Protected Health Information

Authorization to release health care information to a third party.

Information to Parents and Guardians of Minor Children

As a general rule, we require the consent of a parent or legal guardian in order to provide health care services to a minor child (someone under the age of 18).

Contact EBJ Proliance Surgeons

 

We have a knowledgeable staff that can help you determine if our office is contracted with your insurance carrier.

 

Ask The Surgeon Shows

Achilles Tendon Problems
 

Achilles Tendon Problems

Doug Nowak, MD, and Jeff Mason, MD discuss achilles tendon conditions like ruptures, partial tears, tendonitis and what to do.

 

Hip Arthroscopy Surgery

Doug Nowak, MD discusses the extensive training required to be able to perform hip arthroscopy.

Bunions
 

Bunions

Listen to Howard Barker, MD to find out more about prevention and treatment of bunions.

Please take the time to fill out these forms so the process of seeing you goes smoothly. We look forward to seeing you at EBJ Proliance Surgeons.