New Patient Form
Please fill out the following paperwork and bring it to your scheduled appointment.
New Patient Questionnaire
Please remember to bring the following:
Referral (if needed)
Any x-rays of the injured area (if taken in the last six (6) months)
(You can call the hospital or doctor's office and request your x-rays a couple of days prior to seeing Dr. Eagan)
Any testing such as a MRI, Cat Scan or Bone Scan (bring the actual films)
A list of your medications
A list of any allergies
If your injury is work related, or an auto injury, you must bring in the name of the insurance carrier, and your private insurance information.
If your injury is a knee, or ankle please bring a pair of shorts to change into, so you do not have to put on an examining gown.
If you are unsure of your insurance coverage, you may want to call your insurance company before you visit to see if there are any stipulations on your policy in regards to treatment.
Please feel free to call our office if you have any questions or we can be of assistance.