Your Visit

Provided below are various forms that require completion prior to your visit and/or surgery. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. Please bring your completed forms with you to our office at the time of your scheduled visit. This will help expedite the registration process.

To make your check-in process fast, convenient, and more private, we’re introducing a new mobile check-in process.Learn More

Hip & Knee

Please print registration form and any applicable forms from below.

Dr. Bruckner and Dr. Scott only

Hip and Knee Registration forms


Please print registration form and any applicable forms from below.

Neck and Upper Back Form

Lower Back Form

Getting Ready for Your Visit

In order for us to provide you the best care, it is important that you bring the following items to your appointment:

  • Photo ID
  • A list of your current medications
  • Any and all x-ray, MRI’s and or reports if available
  • Insurance information and card
  • Some insurance carriers require you have a referral or primary care authorization before treatment is given. Please check with your carrier.
  • Information about what treatments and medications have been tried in the past
  • Medical records from prior visits that you think may be helpful
  • New Patients: please download a patient registration form below and bring a completed copy with you for your visit.

In order to complete any outstanding paperwork and/or process any required changes to your patient information, we ask that you come to our office at least 20 minutes prior to your scheduled visit time.

Insurance & Billing

If you provide complete and accurate information about your insurance, we will submit claims to your insurance carrier and receive payments for services. Depending on your insurance coverage, you may be responsible for pre-payments, co-payments, co-insurance, or other deductible amounts.

While we participate with most local and many national insurance plans, it is your responsibility to understand whether your insurance has limits on the doctors you can see, or the services you can receive.

Even if we are not contracted with your insurance plan, you may still have some level of coverage for utilizing an out-of-network provider. If you don’t see your insurance carrier listed, please contact our billing office at 425-507-0733 or call your insurance carrier should you have questions about the level of coverage you may have. For a list of insurance companies that were are contracted with please visit our frequently asked questions page.

Office Policies


Please call the office to make an appointment in advance. If you are unable to keep your appointment, please call us as far in advance as possible so we may use that time to see another patient in need of care. We make a sincere effort to adhere to our appointment schedule and appreciate your patience if your physician is running late due to emergencies or hospital surgery.

Prescriptions & Renewals

If you have a prescription that needs to be refilled, please call the pharmacy that last filled your medication at least 24 hours before you will need the medication. If you have a new prescription need, please call our office during business hours. Again, be certain to allow at least 24 hours to make any arrangements for prescriptions.

Contact Us


Novel Coronavirus (COVID-19) Update

Your health is of upmost importance to us. Proliance Orthopaedics & Sports Medicine remains open at our Bellevue and Issaquah locations to serve the medical needs of our patients and community.

We wish to evaluate you as soon as possible. In an effort to do so, we are now offering virtual visits through a secure video-call application. Now, you can meet with your provider from the safety of your own home. Please call to schedule or speak to a staff member who can help answer questions and schedule an appointment (either virtually, or in person if necessary) as soon as possible.

We are prioritizing visits for the treatment of time sensitive conditions per recommendations from the Center for Disease Control (CDC) and the Washington State Department of Health. For the safety of you and other patients, we will be screening everyone before they enter one of our clinics. All providers and employees are also being screened twice daily at all of our locations, in compliance with the latest guidelines

To best protect our patients and staff, all providers you encounter during your visit will now be wearing personal protective equipment (PPE), such as masks.

We ask that you remain at home if you have a cough and/or fever or if you have been exposed to someone with these symptoms. Please contact your primary care provider immediately if you have any of these symptoms. We ask that adult patients who do not need assistance come into the clinic by themselves to limit visitors.

Click here for additional updates from Proliance.