PATIENT AUTHORIZATION FORMS [FOR USA ONLY]


Great news! Your physician has prescribed the Game Ready® System to fast-track your upcoming recovery from orthopedic surgery or injury. Game Ready is the injury treatment system of choice for thousands of prominent orthopedic clinics, athletic trainers, and physical therapy centers. Below, you’ll find the forms necessary to rent the Game Ready System, as well as resources in your community to aid in your recovery.

CoolSystems, Inc. (makers of Game Ready) is proud to be nationally accredited as a healthcare provider through the Community Health Accreditation Program (CHAP). CHAP is the leading independent, non-profit accrediting body committed to improving the quality of community-based healthcare services in the USA.

PATIENT AGREEMENT


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PATIENT ORIENTATION CHECKLIST & AUTHORIZATION AND RELEASE OF MEDICAL INFORMATION, NOTICE OF PRIVACY PRACTICES AND PATIENT BILL OF RIGHTS


Patient Orientation Checklist: This is our way of ensuring that we’ve provided the necessary training, education, and forms for your use of the Game Ready System in your recovery.

Notice of Privacy Practices: Describes how we collect, use, and disclose the information you provide to us and your rights with respect to that information. Describes how medical information about you may be used and disclosed and how you can get access to this information.

Patient Bill of Rights: Describes your rights as a client of Game Ready and as a patient.

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NOTICE OF FINANCIAL RESPONSIBILITY


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ADVANCE BENEFICIARY NOTICE OF NONCOVERAGE


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SUPPLIER STANDARDS


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PATIENT INFORMATION SHEET


Needed to process your rental and/or purchase, including payment and insurance reimbursement information.

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COMMUNITY RESOURCE GUIDE


Provides additional information and support before and after your surgery or injury.

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