All other form requests for the Medical Records Department
Disability, Family Medical Leave Act (FMLA), Unemployment, ADA, Return to Work, etc.
Contact your Human Resources Department: Obtain the necessary forms from your Human Resources department or disability company. It is the patient’s responsibility to complete his/her employer’s forms and provide them to our Medical Records Department.
Authorization is Required: Complete one Orthopaedic Associates of Michigan (OAM) Forms Request for each one of your employer’s forms. The OAM Forms Request(s) will be good for one year unless otherwise stated in writing.
Cost per Request: OAM contracts with Ciox, a professional third-party service that specializes in protecting your health information. The cost for them to process your paperwork is $25 per form. We must receive payment along with your OAM Forms Request(s) before the process can be initiated. You can contact Medical Records to make the payment over the phone at (616) 459-7101 ext. 1880, or you can include a check payable to Orthopaedic Associates of Michigan with your form(s).
Submit Your Paperwork for Completion: Submit your employer’s forms, the OAM Forms Request(s), and the $25 payment for each form that needs to be processed. You can submit your paperwork by:
- Fax to: (616) 336-5042
- Email to: firstname.lastname@example.org
- Drop it off at any of our office locations: 1111 Leffingwell Ave. NE, 555 MidTowne NE, or 2373 64th St. SW, Suite 2500
Follow up with Your Employer: It will take approximately 7-10 business days for your paperwork to be completed and submitted. Follow up with your Human Resources department or disability company to ensure that they have received your completed paperwork.
Status of Forms: If you need to check on the status of your paperwork, please call Medical Records at (616) 459-7101, ext. 1880, Monday – Friday 8 am – 4:30 pm.