PLEASE READ THE FOLLOWING INSTRUCTIONS BEFORE PROCEEDING TO THE FORMS BELOW. Follow instructions A for new patients and B for follow-up.
A1. Use this page to download "new patient" forms. All files are in Adobe Acrobat format. If you do not have the Adobe Acrobat reader, you can download it here.
Once complete, please FedEx the package to:
Thomas P. Gross M.D.
Midlands Orthopaedics & Neurosurgery, P.A.
1910 Blanding St.
Columbia, SC 29201
B1. Use this page to download "follow-up" forms. All files are in Adobe Acrobat format. If you do not have the Adobe Acrobat reader, you can download it here
B2. We request postoperative follow-up at 6 weeks (4 weeks for knees), 6 months, 1 year, 2 years, and every 2 years therafter. You can schedule an in-office visit for each of these intervals by calling (803) 256-4107, or you can complete a remote follow-up. For remote follow-ups, please download the follow-up package below AND READ THROUGH THE INSTRUCTIONS CAREFULLY. PRINT, FILL OUT, AND MAIL IN. We require the following materials for your remote follow-up:
- 6 weeks (4 week knees) - questonnaire, physical exam, x-rays, and mission statement disclosure form
- 6 months - questonnaire, physical exam, and x-rays
- 1 year - questionnaire, physical exam, and x-rays
- 2 year hips - questionnaire, x-rays, and metal ion test | 2 year knees - questionnaire, physical exam, and x-rays
- >2 years - questionnaire and x-rays
New Patient Forms
OUT-OF-STATE PATIENTS: When all information is submitted, Evelyn will send the completed file to Dr. Gross for review. Usually, he will be able to call you within 3 weeks of receiving your information. Please be alert to calls from a blocked phone number or from any phone # with an 803 area code because Dr. Gross will call from home, the office, or the hospital.
I. For initial evaluation (choose one):
- New hip patient packet
- New knee patient packet
II. Information needed to schedule surgery (after initial eval):
- Mission Statement and Disclosure Form
- Please read our Privacy Information Form
- CBC Request (your PCP can order this)
- Please read through Insurance Information carefully
- *Optional/As needed* - Claimant Information for Disability/FMLA Benefits
*Section II forms (not necessary for intial evaluation) ARE REQUIRED PRIOR TO SCHEDULING SURGERY.
I have already recommended your medical facility to several others.
I am so grateful that Dr. Gross was willing to take me as a patient for hip resurfacing on my left hip. With that intervention, I have been active, full of life and productive in the community.
This photo was taken June 3 by a volunteer at the close of the 'Tour de Cure' bicycle event to benefit diabetes research. (This is a national program and two such events were held in Alaska, one in Anchorage and the other in Fairbanks.) There were three levels of participation, 100 km, 50 km and 25 km. Thanks to the hip that is now working, I am happy to say that I completed the 25 km route (along with about 500 other people), had a wonderful time, and raised $150 for diabetes research.
Thank you for restoring such an important aspect of my life.
At 5 months post op now, wow I love, love, love my new hip. I feel as if I have been reborn. Sounds corny, but it is true. I have so much more energy now that it is not going towards how bad my hip hurts! The decision to do HR vs. THR was the best decision I have ever made.
This picture was taken last weekend in Pawley's Island, SC just short of 15 weeks post-op. I am pain-free and am now able to enjoy the things I like to do. I am a professor of physical education and athletic training, I also teach gymnastics and practice yoga.
My range of motion, coordination, even lower back health are all as good as, or better than, they have been for several years.
I have played badminton since the age 9, and competitively for 50 years. Over the years, I have won a couple of US National singles titles, several regional single and doubles titles, have coached little kids, big kids, and college level badminton teams.
In early 2010, it became difficult to play. Osteoarthritis in my left hip made playtime extremely painful; my movements around the court became much slower and a noticeable limp and affect were evident. In June of 2010, I stopped playing altogether, as it had become difficult to even walk.
Kudos to Dr. Gross and his excellent staff for restoring my ability.
11 months following hip resurfacing surgery, that's me participating in the 2011 Escape From Alcatraz triathlon. Diagnosed with osteoarthritis, plus osteopenia, in one hip, I began my rehab 3 months after surgery, doing swimming, indoor cycling and water jogging.
The first few months upon hitting the pavement, I would experience leg pain in the ITB area on the surgical side, which limited my distance. Plus, for a few minutes, I would get a post-run limp. Though I did walk, on purpose, quite a bit at Alcatraz I had neither leg pain or a post-run limp. Kudos to Dr. Gross and his excellent staff for restoring my ability to do triathlons.
Right Uncemented HSR
Very happy and grateful.
I returned to my passion, roller derby, after hip resurfacing with Dr. Gross. Very happy and grateful.
Hip Resurfacing Patient
Thanks to the whole team.
Climbing Mayan Ruins 10 months post hip resurfacing with Thomas Gross, M.D. Very happy!
Thanks to the whole team.
Hip Resurfacing Patient
I NEVER thought about my new hip. It felt very natural.
It's been 7 months now since having my 2nd hip resurfaced and just wanted to let you know things are going well. A couple of days ago I completed a rim to rim to rim hike of the Grand Canyon (all the way across and back, 45 miles with approx. 11,000' total elevation gain).
Along the way, as could be expected, there were some little nagging discomforts–100+ degree heat, back fatigue, sore feet, etc. One thing I NEVER thought about was my new hip.
I'd done lots of training over the last few months to train; lots of hills and very long hikes, (including a couple of 14,000' peaks in CO in July, at 5 months post-op) and throughout that process the hip felt very natural.
Day after day, I was stronger and inspired to get better!
Hi Lee! I am feeling great!! I wanted to share my story with you in hopes that it may inspire others with hope of a great future after Hip/Knee replacement.
I had a right hip resurfacing and a left total knee replacement with Dr. Gross in the same week, one year ago.
At first, going through the initial physical therapy was tough. But day after day, I was stronger and stronger and inspired to get better. I have two young boys and I wanted to actively be part of their lives!
I could not have done it without you guys.
This is me after a 1.2 mile (one way) 792' elevation change hike in Glacier National Park! This was in Canada, overlooking Waterton Lakes. (Just one of many strenuous hikes we made.) 1-year post op on right hip, plus 5 months post op on the left hip.
I could not have done it without you guys, and Dr. Gross, too. I'm also back to playing golf.
- Dave H.
Bilateral Uncemented Recap