Disability, FMLA and Other Medical Forms:
To Complete a Disability/FMLA Form:
1. Please click the link below to begin the disability/FMLA form process; Please DO NOT bring forms to the practice to turn in.
2. Make sure to have your disability or FMLA form with you BEFORE logging in! (You should have received these forms from your disability carrier or employer). No forms are provided on this link.
3. Normal turnaround time to receive your completed form is 5-7 business days. There is an additional fee for expedited requests. Forms not submitted through this link could result in a slower turnaround.
4. You will be asked for payment on this page as well. The cost is $30 per form, $15 for an updated form and $50 for an expedited request (guaranteed 3 day turnaround).
5. FMLA and Disability forms cannot be completed on the same request. These forms must be submitted separately.
6. For any further questions, please contact us via text or phone call at 260-215-6206. Text messages will provide a quicker response.
Estimate Assistance:
ONE patients can request an estimate for non-emergency healthcare services that have been ordered, scheduled or referred by an ONE provider. If you would like an estimate please call our central billing office at 260-408-2501 regarding an estimate.
Patient Education:
General:
Robotic Assisted Surgery:
Foot & Ankle:
Hand:
Joint:
Spine:
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