Caring for Better Life
What to Bring
Please fill out and either bring in or send the information via fax or email from our Patient Resource Page of the following
Upon your 1st visit, any changes since your last visit, or have not been at our office in over six months, please fill out and print the following forms:
Depending on your visit needs please fill out the following:
Also, if you have visited a physician or specialist regarding this or any related condition, please bring all application materials with you such as:
- Medical Records, including surgery notes if applicable
- X-Rays, CT Scans, MRIs, Nerve Studies
- List of medications that you are currently taking and any medical issues you have
(Note: That any person under the age of 18 must be accompanied by a parent or guardian.)
You can also assist Dr. Diefendorf by being prepared to let him know about you with some of the important things about your concern or health issue that we ask of you. Such as:
- What are the current symptoms of your injury or concern that brought you in?
- How long have you had your symptoms? Is this a reoccurring issue?
- What was the diagnosis?
- What treatment plan did the previous doctor or specialty provide you with?
- How long ago did your injury occur?
- Have you had any injury or illness in the general area of the concern/injury in the past?
- Have there been any continuing problems from the previous issue or concern?
- Have you ever had any surgery in the area of the injury or concern you are speaking of today?
- What activities related to sports, work or lifestyle make your symptoms better or worse?
- Do you think that activities related to your job or hobbies caused your symptoms?
- What home treatment measures have you tried? Did they help?
- What non-prescription medicines have you taken? did they help?
