Thank you for selecting OSMC for your orthopedic and sports medicine needs. To schedule an appointment, please call us at (574) 264-0791 or book your appointment now, right online, just click the 'Reserve an Appointment' button. We look forward to seeing you at one of our six convenient locations, where we serve patients from Michiana, or Northern Indiana, and the Southwest Michigan area.
Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process. Please be sure to bring forms with you to your first visit along with any diagnostic films or other test results that may have been ordered or performed by another physician.
If your insurance requires a referral for an office visit, you should coordinate this with the referring physician before your appointment with us. Physical therapy appointments require a referral if you plan to use insurance. Find out more about our referral policy.
Established patients can update forms online through our patient portal. If you need help accessing the portal, please call the office, and we’ll be happy to help.
OSMC Insurance Networks found here: OSMC Insurance Networks OSMC Insurance Networks
New Patient Forms
- Medical History and Orthopedic Screen
- Consents and Authorizations
- Minor Consent Form
- Pain Questionnaire for patients of Dr. Christopher Annis, Dr. David Beatty, and Dr. Jonathan Schrock
Patient Forms – in Spanish
- Consentimientos Y Autorizaciones
- Declaración De Procedimientos De Indiana
- Declaracion De Testament
- Delegación de Autorización para el Consentimiento
- Directivas Avanzadas -Definición de directiva anticipada: término general que describe dos tipos de documentos legales, testamentos en vida y poderes notariales médicos. Estos documentos permiten a una persona dar instrucciones sobre la atención médica futura en caso de que no pueda participar en las decisiones médicas debido a una enfermedad grave o incapacidad. Cada estado regula el uso de directivas anticipadas de manera diferente. 1) Indiana tiene dos documentos legales que protegen el derecho del paciente a rechazar un tratamiento médico que no desea oa solicitar el tratamiento que sí desea en caso de que el paciente pierda la capacidad de tomar decisiones por sí mismo. Los siguientes formularios estarán disponibles en la intranet de OSMC si el paciente lo solicita: La Declaración de testamento vital de Indiana (Declaración A) B. La Declaración de Procedimientos para Prolongar la Vida de Indiana (Declaración B.) 2) En caso de que un paciente se presente al centro quirúrgico con una directiva avanzada / testamento vital, se notificará al director médico o al director de ASC. Se le informará al paciente que las órdenes DNR (No resucitar) no se cumplirán durante la visita perioperatoria. Esta conversación y la comprensión del paciente se documentarán en el.
- Historia Medica Y Exploracion Ortopedica
- Instrucciones Para El Médicos
- Reconocimiento Del Recibir La Notificación De Privacidad De OSMC
- Su Derecho a Decidir
Prescriptions and refills for established patients of OSMC are routinely issued Monday through Friday between the hours of 8 am – 5 pm. You can make your request by visiting our patient portal or call us at 574-264-0791.
Our team will make sure that your request is addressed within 2 business days.
No refills are issued during the evenings, weekends, or holidays, as the doctors do not have access to your medical records during those times. It is helpful to anticipate your refill needs to avoid an interruption in your medication therapy.
Medical Records Request
FAQs about requesting medical records:Q: I need medical records, what do I do? A: To request copies of your medical records please fill out a medical records release form. This form must be completed and signed by the patient, legal guardian, or healthcare Power of Attorney (if completed by the POA then we must have documentation) Completed forms can be emailed, faxed, mailed, or dropped off at any OSMC location. For any questions or any urgent medical records request please call: (574) 970-4468. Medical Records 2310 California Rd. Elkhart, IN 46514 Tel: (574) 970-4468 Fax: (574) 262-5183 Email: firstname.lastname@example.org Q: My form or records were emailed to me, but I am not seeing anything from you in my inbox. What do I do? A: Please check your spam folder first. Private health informaton (PHI) is sent through secure e-mail. You will need to register and validate your email address first, once registered please follow the instructions provided in the email to access your medical records.
Family Medical Leave Act (FLMA) & Disability Forms
Questions about work FMLA / Disability FormsQ: How do I submit a form or request? A: For forms related to a work leave, such as FMLA, disability, or for a work accommodation, please email completed forms to email@example.com or fax to (574)262-9650. Q: How long should I expect for my request to be fulfilled? A: We process forms in the order received and will be processed within 7-10 business days once authorization and payment are received. Please note that incomplete forms will delay the completion process. Q: How do I receive my completed form? A: When you request your form, you specify where it should be sent and if it should be faxed, emailed, mailed, or picked up. Q: Still have more questions? A: Please call the FMLA / Disability dept at: (574) 264-0791, ext. 4399.
Billing QuestionsAt OSMC, we accept workers’ compensation, Medicare, and most major insurance plans. Please contact your insurance company or you may call our office at (574) 264-4163 to find out if we accept your plan.
Accepted Insurance OSMC Insurance NetworksIf your insurance plan requires you to pay a co-payment, co-insurance, and/or a deductible, you will need to pay at the time of your visit. For your convenience we accept cash, checks, Visa, MasterCard, Discover, and Care Credit. If you have a question related to your bill or insurance, please contact our billing specialists at (574) 266-4163. Please visit the billing information page specific to the OSMC Surgery Center if you have questions about charges from this service.
Our Policies. Our Estimate Information.
- No-Show Policy
- Grievance Policy
- Patient’s Rights
- Patient Responsibilities
- Notice of Privacy Practices
- Nondiscrimination Notice
- Good Faith Estimates Uninsured
- Good Faith Estimates Health Plans
- No Surprises Billing Rights and Protections
- OSMC's Machine Readable Files (MRF's) - The link above leads to machine readable files specfically for researchers, regulators and other vendors who analyze data.
- Covid-19 Precautions
Advance DirectivesDefinition of Advance Directive – A general term that describes two kinds of legal documents, living wills and medical powers of attorney. These documents allow a person to give instructions about future medical care should he or she be unable to participate in medical decisions due to serious illness or incapacity. Each state regulates the use of advance directives differently.
- Indiana Do Not Resuscitate (DNR)
- Indiana Life-Prolonging Procedures Declaration
- Indiana Living Will Declaration
- Indiana Physician Orders for Scope of Treatment (Post)