Pre-registration Download Form

Complete your registration papers before coming to the office. Click on the links below to download the registration packet. Then print, fill out, and sign the forms and turn them in upon arrival at our office on the day of your appointment. We will then make a copy of your driver's license and insurance cards and you will be ready to see the doctor!

Note: You will need Acrobat Reader or another PDF viewer to view the forms.

All New Patients must complete the Registration form, financial policy form, and Medical Information form.

Patient Registration.pdf

Patient Review of Symptoms.pdf

Medical Info.pdf

Financial Policy.pdf

Get Your Bayside Records

Release Records to Bayside

Dr Rainer's patients should print, read, and sign the Medication Agreement and Expectation of Care forms.

Medication Agreement.pdf

Expectation of Care.pdf

What is our policy regarding payment and insurance?

Many changes in health care reimbursement have influenced the decisions we have made to adopt the following financial policies:

Patients who have insurance coverage:

Insurance companies with a co-pay clause: The co-payment required under your specific plan is paid at the time of check-in. We are required by contract to collect the co-pay at the time of each visit. Please come prepared to meet the requirements of your specific plan at the time of the visit.

Patients who have coverage with an insurance company with a general benefit plan:

A payment of 20% of the charges incurred is expected at the time of service. The insurance claim will be filed promptly within 48 hours. If there is a remaining balance which the insurance company states is the patient's responsibility we will notify you.

Patients without insurance:

Please discuss your specific needs and make arrangements with the Patient Relations Representative at the time of your first visit to our office. To make payment arrangements or to pay on your account, please call 251-928-2401 and ask for the insurance department.

Patients who were hurt on the job and are covered by Worker's Compensation:

Bayside Orthopaedic's clinical staff is designed to care for the injured worker. Please note that due to specific regulations regarding the treatment of these particular patients, we must follow these guidelines:

The first appointment must be made by the employer or the Work Comp insurance case manager or adjustor.
The insurance information must be verified by our Verifications Clerk.
We must have permission to provide information to the employer and the insurance carrier.
Bayside will bill the appropriate responsible individuals.
No payment is made by the patient.

For more information, call 251-210-3217 or 251-210-3214

General financial and insurance guidelines:

Bayside has contracts with most major carriers. Therefore, the contract guidelines will be followed. However, patients with insurance coverage for non-contracted companies are responsible to follow Bayside's financial guidelines which require payment for services rendered at the time of the visit.

Our Patient Relations Representatives are available to discuss financial arrangements if these are needed. She is available to discuss fees and payments with you at any time.

If you have other questions, please click on Contact Us, and don't hesitate to give us a call at 251.928.2401.