Patient Policies & Forms

Your First Visit

Your first visit to Hampshire Orthopedics & Sports Medicine is a key component of your ongoing medical relationship with our medical staff and we strive to make this a pleasant experience. We ask that you please arrive at least 15 minutes prior to your scheduled appointment time. If possible, please print, fill out the following forms and bring them with you to your appointment. This will make the registration process go more smoothly.

Please download/print & bring the completed form(s) to your appointment.

NEW PATIENT REGISTRATION FORM - Word Document - PDF

NEW PATIENT MEDICAL HISTORY - Word Document - PDF

NOTICE OF PRIVACY PRACTICES - Word Document - PDF

NOTICE OF PRIVACY PRACTICES RECEIPT - Word Document - PDF

RELEASE OF MEDICAL INFORMATION - Word Document - PDF

If you are unable to print and complete the above forms, please arrive at our office 30 minutes before your appointment time to complete the necessary information without delaying your appointment.

Insurance

Hampshire Orthopedics & Sports Medicine participates in most insurance plans. Be sure to bring your insurance card to each visit.  If you are a member of an HMO, please obtain a referral from your primary care physician before your office visit. Please be prepared to pay your co-payment at the time of your visit. We accept cash, personal checks, debit, MasterCard, and Visa.

 Radiology

Please bring any or all existing x-rays pertaining to your orthopedic condition to the office for your first appointment. This may include MRI’s, CT scans, bone scans and plain x-ray films.

Workers' Compensation

Our office does treat worker’s compensation injuries. All contact information must be provided to our office prior to scheduling an appointment. 

Self-Payment Policy

If you do not carry health insurance you will be asked for payment at the time of your visit. Our billing staff will assist you in setting up a payment plan suited to your individual circumstances. Our billing department may be reached at (413) 584-3814.

Free-care is ONLY available at the hospital.

Appointment Re-scheduling

It is at times necessary to re-schedule office appointments due to urgent problems that arise. We prefer not to cancel patient appointments but when that situation arises we will make every effort to accommodate your schedule. Please supply our office staff with alternate phone numbers in the event of emergency cancellations. If it is necessary for you to cancel or re-schedule your appointment with our office, please notify us at least 24 hours in advance.