ABC Accredited

Local. Independent. ABC Accredited.
866.99.OPTECH
info@optechop.com

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Learn more about Optech O&P
Patient Information

"I couldn't walk my dog because of my plantar fasciitis. The pain was too much. Marty fitted me with these amazing custom inserts. I'm now running in races!"
-- Tom Z.

Patient Information

First Visit & Forms

Have an appointment to visit us? This is what you should bring with you for your first visit at Optech O&P:

  • Your prescription or referral from the ordering physician
  • Your up-to-date insurance cards or work comp information
  • A Picture ID

Please review the following forms. You will be asked to sign these forms prior to seeing the practitioner:

Pre-visit Forms Description
New Patient Form (PDF) This is the official patient entry form. All new patients complete this form prior to seeing the practitioner.
Prosthetic Patient Assessment Form (PDF) Prosthetics patients complete this form to help the practitioner best understand the patient condition and experience in order to fit the best device.
Assignment of Benefits Form (PDF) This form allows Optech O&P to bill insurance for patient services.
Financial Policy Form (PDF) This form is the Optech O&P service policy which explains when payments are due depending on what is or isn't covered by insurance.
Consent of Photograph Form (PDF) Most insurance policies require photos. This form allows Optech O&P to take pictures of the patient, with or without the device, to help process insurance claims.
Patient Acknowledgement of Receipt (PDF) Patients will sign this form to acknowledge they have received the Notice of Privacy Practices.
Notice of Privacy Practices (PDF) This document informs patients about the use of their medical information and their rights to privacy.

What you need to wear on the day of getting your product:

  • Wear comfortable clothing
  • Wear tie or Velcro shoes if getting fit with a leg brace
  • If you are being fit with a prosthesis, be sure to bring shoe for the sound side
  • Co-payment for product (if applicable)

If you have any questions or concerns, please contact us. We're here to help.