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
- 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):
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.