Welcome Orchard Medical Injured Worker Patients
For your convenience, you can read and sign all of your paperwork from the Menu on the left.
Release of Information (As Needed)
An Release of Information is required before we can share your protect 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.
Click Here to Sign all Enrollment Forms (One Time Only)
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 Recovery Help
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.
Email your questions to firstname.lastname@example.org or talk to your Orchard Nurse/Case Manager.