New Patient Forms
This questionnaire should be completed before your initial evaluation and interview with Dr Hepler. For any questions preparing this document please contact our Delray Beach office or our Fort Lauderdale office for further information or instructions.
This questionnaire should be completed before your surgery and at 3, 6, 12, 24 month follow up visits. For any questions preparing this document please contact our Delray Beach office or our Fort Lauderdale office for further information or instructions.
This questionnaire has been designed to give the doctor information as to how your back trouble (or leg) has affected your ability to manage in everyday life.
This questionnaire has been designed to give the doctor information as to how your neck pain has affected your ability to manage in everyday life.
Patient Financial Responsibility Statement
This document outlines details of the financial responsibility on your part for the medical services you seek with us.
This Notice of Privacy Practices describes how we may use, and disclose, your protected health information (PHI) to carry out treatment, payment, or health care operations (TPO) and for purposes required by law and describes your rights to access and control your protected health information.
