Patient Resources

To schedule an appointment, please call us at (701) 946-7400 or (866) 900-8650, or use our online appointment request form.

Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process.

Please be sure to bring forms with you to your first visit along with any diagnostic films or other test results that may have been ordered or performed by another physician.

Established patients can update forms online through our patient portal. If you need help accessing the portal, please call the office and we’ll be happy to help.

The Bone & Joint Center makes it easy and convenient for you to manage your health care online. Once you register, you can log in to the patient portal at any time to:

• Request an appointment
• Complete patient forms
• Request prescription refills
• Request and view your medical records and test results
• Pay your bill
• Complete our patient satisfaction survey
• Communicate with our office

If you are new to our patient portal, please keep the following in mind:

• If you have not received authorization to begin using the portal, call our office at (701) 946-7405 to request a link be sent to your email.
• Once you receive the invite, follow the directions to create a new account. You will create your user ID and password.

If you have already registered for our patient portal:

• At the patient portal entry page, enter the user name and password you selected when you registered, and click "Sign In."

Contact us at (800) 424-2663 if you have questions about using the portal.

Disclaimer: If you register, make an appointment or submit any other information online, all your information is transmitted securely and is held in strictest confidence, adhering to HIPAA guidelines and protecting your privacy.

Interactive Form

• Medical Release

Downloadable Forms:

• New Patient Packet, including Symptoms Checklist and Medical History
• Medical Release
• Patient Instructions / Protocols

Please note:  It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

We invite you to explore our comprehensive list of resources and educational materials designed to help educate you about your orthopedic condition or treatment.

• General inquiries: (701) 946-7500 or (800) 424-2663
• Appointments: (701) 946-7400 or (866) 900-8650
• Surgery Scheduling: (701) 946-7403
• Nursing: (701) 946-7404
• Total Joint Education: (701) 946-7399
• After-Hours Medical Needs: (701) 530-7000 – ask for the orthopedic surgeon on call
• Billing: (701) 946-7402
• Prescription Refills: (701) 946-7404
• Dickinson Main Line: (701) 456-6494
• Dickinson Nursing: (701) 456-4793
• Dickinson Surgery & Procedure Scheduling: (701) 456-4728

See the list of affiliates of The Bone & Joint Center on the About Us page of this website, including:

• Bismarck Surgical Association (BSA)
• CHI St. Alexius Health Bismarck
• CHI St. Alexius Health Dickinson
• Mid Dakota Clinic
• Pain Treatment Center
• PrimeCare Health Group
• West River Health River Services

Additional Resources:

• American Academy of Orthopaedic Surgeons (AAOS) – Founded in 1933, the AAOS is the preeminent provider of musculoskeletal education to orthopedic surgeons and others around the world. Its continuing medical education (CME) activities include a world-renowned annual meeting, multiple CME courses held around the US and at the Orthopaedic Learning Center, and various medical and scientific publications and electronic media materials. Phone: (847) 823-7186

• American Association of Hip and Knee Surgeons (AAHKS) – Established in 1991, the mission of the AAHKS is to advance hip and knee patient care through education and advocacy. Phone: (847) 698-1200

• American Orthopaedic Society for Sports Medicine (AOSSM) – The mission of AOSSM is to be the premier global sports medicine organization representing the interests of orthopedic surgeons and other professionals who provide comprehensive health services for the care of athletes and active people of all ages and abilities. AOSSM cultivates evidence-based knowledge, provides extensive educational programming, and promotes emerging research that advances the science and practice of sports medicine. Phone: (847) 292-4900

• American Society for Surgery of the Hand (ASSH) – Since 1946, ASSH has grown from 35 surgeons excited about sharing ideas to more than 3,800 members spanning the entire globe who are all dedicated to advancing the science and practice of caring for your hands and arms. Phone: (312) 880-1900

• Arthritis Foundation (AF) – The Arthritis Foundation leads the fight for the arthritis community through life-changing information and resources, access to optimal care, advancements in science and community connections. Their goal is to chart a winning course and make each day another stride toward a cure.

• Arthritis National Research Foundation (ANRF) – Since 1970, the ANRF has funded arthritis research to understand the causes, prevention, and development of new treatments for osteoarthritis, rheumatoid arthritis, lupus, juvenile arthritis and other autoimmune diseases. Phone: (800) 588-2873

• The American Society of Orthopedic Professionals (ASOP) – In 1999, ASOP was founded to decisively offer the orthopedic technologist an organization that was established and managed by orthopedic technologists. For the last 20 years, ASOP has continued to fulfill this primary objective for the orthopedic profession. Phone: (727) 394-1700

• Arthroscopy Association of North America (AANA) – The AANA is an international professional organization of more than 4,000 orthopedic surgeons and other medical professionals who are committed to advancing the field of minimally invasive orthopedic surgery to improve patient outcomes. Phone: (847) 292-2262

• North Dakota Orthopaedic Society (NDOS) – 1622 E. Interstate Avenue, Suite A, Bismarck, ND 58503-0512. Phone: (701) 223-9475

• Wilderness Medical Society (WMS) – Founded in 1983, the WMS is the world's leading organization devoted to wilderness medical challenges. Wilderness medicine topics include expedition and disaster medicine, dive medicine, search and rescue, altitude illness, cold- and heat-related illness, wilderness trauma, and wild animal attacks. WMS explores health risks and safety issues in extreme situations such as mountains, jungles, deserts, caves, marine environments, and space. Phone: (801) 990-2988

You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don’t have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call (701) 946-7500.

Our Pledge to You:
We understand that medical information about you and your health is personal, and we are committed to protecting your privacy while providing quality care. This Notice of Privacy Practices applies to all records generated by The Bone & Joint Center.

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY.

We are legally required to protect the privacy of your health information. We call this information "Protected Health Information" (PHI). It includes information that can be used to identify you. This includes information that we have created or received about your past, present, or future health or condition, the provision of healthcare to you, or the payment for health care services. We must provide you with this notice about our privacy practices that explains how, when, and why we use and disclose your PHI. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. We are also required to notify you if a breach occurs that may compromise the privacy or security of your PHI.

Effective Date of this Notice:

The effective date of this notice is March 1, 2022. We reserve the right to change the terms of this notice and our privacy policies. Any changes will apply to the PHI that is currently in our possession. When we make a change to our policies, we will promptly change this notice and post a new notice in our main reception areas and on our website www.bone-joint.com. You may also request a copy of this notice from our Privacy Officer, (701) 946-7500 or toll-free 1-800-424-2663.

HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION:

We use and disclose PHI for many different reasons. For some of these uses or disclosures, we do not need your written permission (authorization), but for others, we do.

Uses and Disclosures That Do Not Require Your Authorization: We may use and disclose your PHI without your authorization for the following reasons:

For Treatment. We may disclose your PHI to physicians, nurses, medical students, and other health care personnel who provide you with health care services or are involved in your care within and outside of The Bone & Joint Center. For example, if you are being treated for a knee injury, we may disclose your PHI to the physical therapist in order to coordinate your care.

For Payment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. For example, we may provide portions of your PHI to your health plan to get paid for the health care services we provided to you. We may also share PHI with your health plan regarding a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

For Healthcare Operations. We may disclose your PHI in order to operate The Bone & Joint Center. For example, we may use your PHI in order to evaluate the quality of health care services that you received. We may also provide your PHI to our accountants, attorneys, consultants, and others in order to make sure we are complying with the laws that affect us. We may also combine the medical information we have with medical information from other similar organizations to compare how we are doing and to see where we can make improvements in the care and services we offer.
We arrange to provide some services through contracts with business associates. On occasion, we may disclose your PHI to business associates acting on our behalf so they can perform the services that we have asked them to provide. To protect your PHI, however, we require the business associate to appropriately safeguard your information.

For Legal Proceedings or Law Enforcement. We may disclose your PHI if required by federal, state or local law, for judicial or administrative proceedings, or to assist law enforcement.

For Public Health Activities. We may report your PHI to public health officials about births, deaths, and various diseases to government officials in charge of collecting that information. We may also provide PHI to coroners, medical examiners, and funeral directors relating to an individual's death.

For Health Oversight Activities. We may provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.

For Purposes of Organ Donation. We may notify organ procurement organizations to assist them in organ, eye, or tissue donation or transplants.

For Research Purposes. In certain circumstances, we may provide PHI in order to conduct medical research.

To Avoid Harm. In order to avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.

For Specific Government Functions. We may disclose PHI of military personnel and veterans in certain situations. We also may disclose PHI for national security purposes, such as protecting the president of the United States or conducting intelligence operations.

For Workers' Compensation Purposes. We may share your PHI as permitted or required by state law relating to workers' compensation or other similar programs.

Appointment Reminders and Health Related Benefits or Services. We may use PHI to set up and provide you with appointment reminders, registration forms, surveys, or to give you information about treatment alternatives or other health care services or benefits we offer.

Uses and Disclosures that Require an Opportunity to Object

Disclosures to Family, Friends, or Others. We, using our best judgement, may disclose to a family member, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. If family members or friends are present while care is being provided, we will assume your companions may hear the discussion, unless you state otherwise. If you do not want us to disclose your health information to your family members or others who are involved with your care or handling your bills, please inform the person assisting you during registration.

Record Locator Services (also known as Health Information Exchange). To facilitate quality patient care, we may share your PHI with a medical record locator service. This information will help caregivers identify where you have a health record(s) and will assist caregivers to make better decisions about your treatment. If you do not want to be included in the record locator service, you may opt-out by completing a written request and submitting it to The Bone & Joint Center medical records department or by contacting the privacy officer at 701-946-7500. Your opt-out decision will remain in effect until you notify us in writing that you wish to change these instruction.

Fundraising Activities. We may use or disclose certain PHI for fundraising activities, but you may tell us not to contact you again.

Uses and Disclosures That Require Your Authorization:
For any purpose other than those described above, we may use or share your PHI only with your written permission (authorization). There are some uses and disclosures that specifically require your authorization including uses and disclosures that relate to psychotherapy notes, marketing activities in which we would receive remuneration from a third-party, and the sale of your PHI.

YOUR RIGHTS REGARDING YOUR PHI:

The Right to Restrict or Limit Uses and Disclosures.
You have the right to ask us to restrict or limit the PHI we use or disclose about you for treatment, payment or healthcare operations. We will consider your request, but we are not required to accept it. If you pay for a health care service or item out-of-pocket and in full, then you may ask us not to share that information with your health insurer. If we accept your request, we will comply unless the information is needed to provide emergency treatment. Your request for restrictions must be made in writing and submitted to the Privacy Officer.

The Right to Receive Confidential Communications. You have the right to request, in writing, that we send information to an alternate address or by alternate means (for example, by e-mail instead of regular mail). We will accommodate reasonable requests.

The Right to Inspect and Copy Your PHI. You have the right to request, in writing, to inspect and obtain a copy of your PHI. We will work with you to provide it in a reasonable electronic form or format. We may charge a fee for the costs of copying, mailing or other supplies and services associated with your request. We will respond to you within 30 days after receiving your written request.

If we deny your request to inspect or obtain a copy in certain limited circumstances, you may be able to request that the denial be reviewed (the grounds for denial must be reviewable by law). If such review is agreed upon, another licensed healthcare professional chosen by The Bone & Joint Center may review your request, and we will comply with the outcome of that review.

The Right to Get a List of the Disclosures We Have Made. You may make a written request for an accounting of certain disclosures of your PHI made by us within the six years prior to the date of your request. We will respond within 60 days of receiving your request. The list will include all disclosures except for those made for treatment, payment, and health care operations and certain other disclosures, including those you asked us to make. We will provide the list to you at no charge, but if you make more than one request during a 12-month period, then we will charge you a reasonable, cost-based, fee for each additional request.

The Right to Amend or Correct Your PHI. You have the right to request an amendment to your PHI that you believe is incorrect or incomplete. If you want to amend your records, then you must make the request in writing and provide your reason for the amendment. We will review and respond to your request within 60 days. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. We may also deny if you ask us to amend information that is: 1) not created by The Bone & Joint Center; 2) is not a part of the medical information kept by The Bone & Joint Center; 3) determined to be accurate and complete.

The Right to Get This Notice by E-Mail. You have the right to get a copy of this notice by e-mail. Even if you have agreed to receive this notice by e-mail, you also have the right to request a paper copy of this notice. You also may obtain a copy of this notice from our website at www.bone-joint.com.

The Right to Revoke Your Written Permission (Authorization). You may revoke an authorization you gave previously, provided the revocation is in writing. The revocation will not apply to the extent we have already acted in reliance on the authorization. If you revoke your permission, then we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand, however, that we are unable to take back any disclosures we already made with your permission and we are required to retain our records of the care we provided to you.

FOR MORE INFORMATION OR TO REPORT A PROBLEM:

If you have questions and/or would like additional information regarding any rights included in this Notice of Privacy Practices, or if you believe your privacy rights have been violated, then you may contact our Privacy Officer by dialing (701) 946-7500 or toll-free 1-800-424-2663 or writing to:

The Bone & Joint Center
Privacy Officer
310 N 9th St
Bismarck, ND 58501

You may also obtain information about how to file a complaint by contacting the Office for Civil rights at:

Region VIII Office for Civil Rights
U.S. Department of Health and Human Services
999 18th Street, Suite 417
Denver, CO 80202
Voice Phone 1-800-368-1019
FAX (303) 844-2025
TDD 1-800-537-7697

There will be no retaliation for filing a complaint.

Mobile information will not be shared with third parties/affiliates for marketing/promotional purposes.