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  • HOME
  • ABOUT US
    • History
    • What Sets Guilford Orthopaedic Apart
    • What our patients are saying
    • Facilities Tour
  • SERVICES
    • Surgical Procedures
      • Sports Medicine
        • ACL Reconstruction
        • Patellofemoral Ligament Reconstruction
        • Knee Ligament Reconstruction
        • Labral Repairs
        • Rotator Cuff Repair
        • Shoulder Arthroscopy
        • Knee Arthroscopy
      • Joint Replacement
        • Total Hip Replacement
        • Total Knee Replacement
        • Total Shoulder Replacement
      • Spine Surgery
        • Cervical, Thoracic and Lumbar Decompression
        • Lumbar Microdiscectomy
        • Spinal Reconstruction and Fusion
        • Minimally Invasive Sacroiliac Joint Fusion
        • Kyphoplasty
        • Spine Trauma
      • Shoulder Surgery
        • Total Shoulder Replacement
        • Rotator Cuff Repair
        • Labral Repairs
        • Shoulder Arthroscopy
        • Surgery for Shoulder Dislocations
      • Hand Surgery
      • General Orthopaedics
        • Fracture Management
        • Shoulder Arthroscopy
        • Knee Arthroscopy
    • Nonsurgical Services
    • Therapy Services
      • Hand Therapy
      • Medical Acupuncture
      • Non-Invasive Pain Management
      • Physical Therapy
      • Spinal Injection
    • Diagnostic
      • Digital X-Ray
      • EMG/NCV
      • Fluoroscopy
      • Magnetic Resonance Imaging (MRI)
      • Ultrasound
    • Outreach Services
      • Sports Physicals
      • Team Partnerships
    • Worker’s Compensation – Independent Medical Exams
      • Industrial Rehabilitation
        • Functional Capacity Evaluation
        • Fitness for Duty Test
        • Job Site Evaluation
        • Work Conditioning
        • Post-Offer Employment Screening
        • Workstation Evaluation
  • PROVIDERS
    • Physicians
      • Frank Rowan, MD
      • Peter Dalldorf, MD
      • John Graves, MD
      • Jesse Chandler, MD
      • Mark Dumonski, MD
      • David Thompson, MD
      • Chris Adair, MD
      • Bradley Wham, MD
      • Dominic McKinley, MD
      • Hao Wang, MD
      • Vincent Paul, MD – Retired
    • Physician Assistants
      • James Bethune, PA-C
      • Jesse Jordan, PA-C
      • Kayla McKenzie, PA-C
      • Andrew Nida. PA-C
      • Eric Phillips, PA-C
      • Amber Porterfield, PA-C
      • Kirsten Schrader, OPA-C
      • Michael Carnaghi, PA-C (Retired)
    • Physical Therapist
      • Ray Kargo, MSPT-Director
      • Nikki Rogers PT, Cert. MDT
      • Suzanne Lang, PT, ATC
      • Andrew Ingle, MPT
      • Paige Becker, PT DPT
    • Physical Therapist Assistants
  • NEWS & EVENTS
    • Holiday Hours
  • PATIENT EDUCATION
    • Articles by Staff
    • Frequently Asked Questions
    • Accepted Insurance
    • Medical Records Policy
    • Payment Policy
    • Prescription Policy
    • Patient Forms
    • Privacy Policy (HIPAA)
  • CONTACT US
    • Contact Form
    • Map, Directions and Hours
    • Employment Opportunities

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SAME DAY APPOINTMENT

To Schedule a Physician Appointment: 336-275-3325

To Schedule a Physical Therapy Appointment: 336-275-7405

1915 Lendew St. Greensboro, NC 27408

Authorization to Release PHI (Personal Health Information) for Workers Compensation

Posted on December 19, 2014 by don

Authorization to Release PHI (Personal Health Information) for Workers Compensation

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← Authorization to Release PHI (Personal Health Information) for Workers Compensation

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To schedule an appointment:
Physician: 336-275-3325
Physical Therapy: 336-275-7405

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Specializing in these areas:
  • Orthopaedic Surgery
  • Therapy Services
  • Diagnostic Services
  • Worker’s Comp/IME

  • Sports Medicine
  • Sports Physicals
  • Industrial Rehabilitation
footer-logo 1915 Lendew St.
Greensboro, NC 27408
Phone: 336-275-3325
Copyright 2014 - 2024 Guilford Orthopaedic and Sports Medicine Center. A division of Southeastern Orthopedics Specialist.
Guilford Orthopaedic
  • HOME
  • ABOUT US
    ▼
    • History
    • What Sets Guilford Orthopaedic Apart
    • What our patients are saying
    • Facilities Tour
  • SERVICES
    ▼
    • Surgical Procedures
      ▼
      • Sports Medicine
      • Joint Replacement
      • Spine Surgery
      • Shoulder Surgery
      • Hand Surgery
      • General Orthopaedics
    • Nonsurgical Services
    • Therapy Services
      ▼
      • Hand Therapy
      • Medical Acupuncture
      • Non-Invasive Pain Management
      • Physical Therapy
      • Spinal Injection
    • Diagnostic
      ▼
      • Digital X-Ray
      • EMG/NCV
      • Fluoroscopy
      • Magnetic Resonance Imaging (MRI)
      • Ultrasound
    • Outreach Services
      ▼
      • Sports Physicals
      • Team Partnerships
    • Worker’s Compensation – Independent Medical Exams
      ▼
      • Industrial Rehabilitation
  • PROVIDERS
    ▼
    • Physicians
      ▼
      • Frank Rowan, MD
      • Peter Dalldorf, MD
      • John Graves, MD
      • Jesse Chandler, MD
      • Mark Dumonski, MD
      • David Thompson, MD
      • Chris Adair, MD
      • Bradley Wham, MD
      • Dominic McKinley, MD
      • Hao Wang, MD
      • Vincent Paul, MD – Retired
    • Physician Assistants
      ▼
      • James Bethune, PA-C
      • Jesse Jordan, PA-C
      • Kayla McKenzie, PA-C
      • Andrew Nida. PA-C
      • Eric Phillips, PA-C
      • Amber Porterfield, PA-C
      • Kirsten Schrader, OPA-C
      • Michael Carnaghi, PA-C (Retired)
    • Physical Therapist
      ▼
      • Ray Kargo, MSPT-Director
      • Nikki Rogers PT, Cert. MDT
      • Suzanne Lang, PT, ATC
      • Andrew Ingle, MPT
      • Paige Becker, PT DPT
    • Physical Therapist Assistants
  • NEWS & EVENTS
    ▼
    • Holiday Hours
  • PATIENT EDUCATION
    ▼
    • Articles by Staff
    • Frequently Asked Questions
    • Accepted Insurance
    • Medical Records Policy
    • Payment Policy
    • Prescription Policy
    • Patient Forms
    • Privacy Policy (HIPAA)
  • CONTACT US
    ▼
    • Contact Form
    • Map, Directions and Hours
    • Employment Opportunities