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Patient Resources //

First Visit to Real Life Prosthetics


First Visit //

Thank you for your interest in Real Life Prosthetics. 

With each first visit, typically there are several forms to fill out which can be very time consuming.  For your convenience, and to expedite your first visit with us, we have provided the forms for you, here on the website, that you can print, fill out and bring with you to your first appointment.  You can either click on each individual form or you can click the "Print ALL First Visit Forms" to print all 15-pages at once.

We accept Medicare, Medicaid and most major insurances.

If you have any questions or would like to verify we accept your insurance, please do not hesitate to call our office at (410) 569-0606, and we will be more than happy to answer any questions you may have about your upcoming appointment.

 

Thank you, and we are looking forward to seeing you soon!

Real Life Prosthetics


Quick Links //

Real Life Prosthetics invites you to explore our website and trusted resources. To learn more about our team, click "About Us." For insights into the first 24 months of an amputee’s journey, visit "Journey of an Amputee." If you’re interested in resources or industry terminology, click "Links and Resources." To understand our rehabilitation model, click "Physical Therapy."

 

Thank you for trusting Real Life Prosthetics. Discover what sets us apart by visiting any of our five clinics across Maryland and Delaware.

  • Patient Medical History Form  PDF

  • Patient and Insurance Information Form  PDF

  • Patient Agreement Form  PDF

  • Acknowledgement of Receipt Form  PDF

    • Notice of Privacy Practices and Patient Email/Text Message Informed Consent  PDF

    • Financial Policy and Procedures  PDF

    • Appointment and Funding Procedures  PDF

    • Medicare DMEPOS Supplier Standards  PDF  (Medicare Patients Only)

Download and Print

ALL First Visit Forms

15-Pages

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