Practice Policy Update regarding COVID-19

Injury Form

Please fill this form as accurately as possible to the best of your ability to help us treat you.

Patient Name:

How you were injured?

Car Accident
Hit By Car
Motorcycle Accident
Work related injury / Workman Comp
School/ sports injury. - Which school or Sports Team?
Other (please describe):

Date of injury:

Body Parts injured (include right or left):

Please describe how the injury occurred and where on the date you listed above:

Signature of Patient or Guardian:

Covid-19 Screener

Please fill this form as accurately as possible to the best of your ability to help us treat you.

As you are aware, due to the current COVID-19 coronavirus pandemic, we must make every effort to insure that all safety measures have been taken to protect our patients, staff, and families.

It is mandatory that the following COVID-19 screening form is filled out by every patient and submitted prior to every office visit.

Please fill out this form to the best of your ability and as truthfully as possible to help us maximize the safety of our patients, staff, and families. Answering yes to any of the screener questions does not mean that service will be denied.

Name :

Yes No

Yes No

Yes No

Yes No

A Message About The Current COVID-19 Precautions Taken at New Edge Orthopedics, LLC

To all our friends, families, patients, and supporters, we are blessed to report that New Edge Orthopedics, LLC is back on track and reopened while making accommodations in response to this unprecedented challenge/ pandemic. We are exercising great care ensuring that we provide the safest environment possible for our patients, staff, and families including:

  1. Maintaining strict social distancing and mask policy, (Surgical grade masks, gloves, and sanitizer available)
  2. Touch-less temperature checks prior to entry beyond the front desk
  3. COVID-19 screening prior to appt (on our website or via phone interview)
  4. Rigorous sanitizing of all patient areas (the waiting room, exam rooms, bathrooms, and x-ray room with CDC approved anti-viral disinfectant wipe down and UV-C light anti-viral treatment throughout the day between every patient
  5. UV-C light air purifiers running full time sanitizing and filtering the air circulated in the office
  6. Careful timing of patients’ appts to ensure that there is minimal overlap and wait times with the goal of avoiding having any patients in the waiting room throughout the day as much as possible
  7. We ask all patients to check-in just prior to their appt before coming up

We look forward to celebrating unity as we work together fighting this pandemic while providing the Best Orthopedic Sports Medicine and Joint Preservation care to our Patients and Family.

Stay safe & healthy!
All of us at NEO