Please print and complete document at bottom of page or arrive 5-10mins prior to appointment to complete paperwork
Please wear appropriate clothing to allow us to properly assess your bracing requirements. i.e., shorts for a knee or ankle.
Every insurance company is different and some policies require quite a bit of documentation beyond submitting your receipt (i.e., Prescription, Pre-Authorized approval etc.). This document contains information that will help you determine if your brace will be covered by your extended health benefits. The answers to these questions can be found in your insurance provider's policy description or by calling the toll free number on your group benefits card. Extended health benefits plans can often email you a .pdf file providing you these answers. Fernie Athletic Therapy will not be held responsible if your claim is rejected.