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Welcome to:
Upper
Bucks Orthopaedic Association
711
Lawn Avenue, Sellersville, PA 18960
215-257-3700
Printable registration and medical history forms are located below.
Keep this page for your records.
Thank you for choosing
Upper Bucks Orthopaedics for your orthopaedic care. We try to
respond to your needs as quickly as possible and are always
available to discuss your medical and financial concerns. To do
this, we will need your assistance. The following is a list of
items you will need to know.
1. Payment for office
visit is expected at the time of service.
2. There is a $25.00 charge for returned checks.
3. UBO needs to be notified of any change of address, telephone
number or insurance.
4. Prescription requests should be made during our business hours.
5. Be sure to bring any x-ray films, MRIs, CT scans, bone scans or
laboratory reports with you to your visit.
6. There is a charge (per form) for the preparation of certain
specialty forms.
7. Tell us about any changes in your medical condition.
8. We will need back-up insurance information or referral in
case your care is not covered by the insurance you identify as
Primary. This is for your protection.
MANAGED
CARE:
Member
card, Co-pay, and Referrals are required at each visit.
If you do not bring a
referral you will be expected to sign the form required by Managed
Care Organization agreeing to pay for services if a referral cannot
be obtained.
We
accept Cash, Check, MAC or Credit Cards.
Please put your account number on all payments.
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