Welcome Orchard Medical Injured Worker Patients
For your convenience, you can read and sign all of your paperwork from the sidebar on the right.
Release of Information (As Needed)
A Release of Information is required before we can share your protected health information with anyone. This may include your spouse, parents, court, attorney, etc. Each person or organization should be submitted on a separate form. You can revoke your permission anytime by submitting the same form indicating that you are revoking permission.
Please complete all 5 forms. If you stop in the middle, you will need to start over.
- Consent for Treatment
- Member Rights
- Program Rules
- Financial Agreement
- Release of Information between Orchard Medical and Core Recovery
Nurse/Case Manager Only
Your Nurse/Case Manager will fill out your Patient Profile for you. You do not need to fill it out again.
Visit our Contact page and get in touch with us.