Patient Forms

 New Patient Forms

Please submit all initial evaluation materials (please review the packet in its entirety, using the first page as a checklist) before your first visit. All section II forms are required before scheduling your surgery. If you are a new patient and would like assistance with preparing or submitting your new patient package, please contact Evelyn W at (803) 933-6170 or email at This email address is being protected from spambots. You need JavaScript enabled to view it. .

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):

1. New hip patient packet
2. New knee patient packet

II. Information needed to schedule surgery (after initial eval):

1. Mission Statement and Disclosure Form
2. Please read our Privacy Information Form
3. CBC Request (your PCP can order this)
4. Please read through Insurance Information carefully
5. *Optional/As needed* - Claimant Information for Disability FMLA benefits

*Section II forms (not necessary for intial evaluation) ARE REQUIRED PRIOR TO SCHEDULING SURGERY.

Follow-Ups

For a postoperative FOLLOW-UP evaluation, please click one of the following links, download the form and mail to us along with your x-rays. Dr. Gross will review your material, have his staff send confirmation to you via email, and he will personally contact you ONLY to notify you of any concerns or at your request. If you have difficulties with this, please call Sherri at 803-933-6101 or email us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Hip Follow-Up Packages

*choose your closest postoperative interval*

1. 6-week hip package
2. 1-year hip package
3. 2-year hip package
4. >2-year hip package

Knee Follow-Up Packages

*choose your closest postoperative interval*

1. 2 to 4-week knee package
2. 3-month, 1-year, or 2-year knee package
3. >2-year hip package

Patient Care Paths

1. Total Hip Arthroplasty Care Path
2. Total Knee Arthroplasty Care Path

Surgical Risk Disclosure

1. Hip Resurfacing Consent Form
2. Total Hip Arthroplasty
3. Total Knee Arthroplasty

Others

1. Hospital Discharge Instructions
2. Phase I Hip Exercise
3. Phase II Hip Exercises
4. Psoas Stretching Testimonial
5. Postoperative Knee Exercises
6. Disability Form
7. Medical Records Request Packet