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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.
Printing and completing these forms can save you time at check-in and improve the efficiency of your processing. Please Click on the form to get a printable copy of the form. You will need adobe acrobat reader to access these forms; If you do not have adobe acrobat reader please
CLICK HERE to Download
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. Please read the Financial Policy (available below) for complete details.
2. Payment for office visit is expected at the time of service.
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 pay in full at the time of service or reschedule your appointment.
We accept Cash, Check, MAC or Credit Cards.
Please put your account number on all payments.
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