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Patient forms Human Technology

PATIENT DOCUMENTATION

Human Technology and Its Affiliates have been providing orthotic and prosthetic services to Tennesee and surrounding residents since 2009. To assist with your appointment, please review these patient forms in advance, feel free to download and bring to your appointment. 

Please contact us at 800.922.1584 or CLICK HERE to send a message directly to us to learn more, or to set up a meeting with our team.

PATIENT ACKNOWLEDGEMENTS / PATIENT DOCUMENTATION RECEIPT
HIPAA NOTICE OF PRIVACY PRACTICES
MEDICARE SUPPLIER STANDARDS
COMPLAINT RESOLUTION PROTOCOL / WARRANTY INFORMATION
PATIENT BILL OF RIGHTS AND RESPONSIBILITIES
FINANCIAL POLICY

Human Technology Prosthetics & Orthotics – Office Closure Notice, Monday, January 26 Due to the Winter Storm Warning, our Tennessee and Mississippi offices will be closed Monday, January 26. The safety and well-being of our patients and employees is our top priority. We plan to reopen Tuesday, January 27, but please stay tuned to our website and/or Facebook page for updates. Be safe and take care.