Southeastern Spine
Southeastern Spine

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new patients

New Patients

Below you’ll find helpful links and resources that will guide you through the process of becoming a patient at Southeastern Spine.

First, Schedule an Appointment, then click through each of the links below for more info.

Non Discrimination & Interpreter Services Notices

Preparing for your Visit

Please bring the following when you visit Southeastern Spine for your first appointment with Dr. Jolley.

  1. Please fill out and complete a New Injury Patient Demographic Info Form
  2. Your Insurance Card
  3. Co-payment (if required by insurance). We accept cash, major credit cards or personal check.
  4. Referral paperwork (if required by your insurance).
  5. Medical records and imaging reports, x-rays, and/or disc with imaging pertaining to your treatment from other health care providers (if you have them).

All New Patients filing with private health Insurance also bring:

  1. Personal Injury Insurance Filing Selection Notice
  2. Patient HIPAA Disclosure Release Form
  3. Insurance card
  4. Driver’s License or other form of Valid Photo ID

All New Patients filing with Workers Compensation, please bring:

  1. Personal Injury Insurance Filing Selection Notice with Date of Injury
  2. Patient HIPAA Disclosure Release Form
  3. Workers Compensation Company Name with mailing address, phone number and claim Number. We will also need the name of your adjuster and their contact info.
  4. Driver’s License or other form of Valid Photo ID

All New Patients that have been in an Auto Accident, please bring:

  1. Patient Filing Health Insurance Demographics Info Form
  2. Patient HIPAA Disclosure Release Form
  3. Auto Accident Attorney Letter of Protection
  4. Attorney Name and Phone number
  5. Driver’s License or other form of Valid Photo ID

(If patient of Dr Jolley’s from previous practice you will need to contact Center for Sports Medicine and Orthopedics directly to request records to be sent to his new office at Southeastern Spine. Our fax number is 888-959-1015. Due to HIPAA regulations signed authorization is required. Download, print and fill out the Records Release Authorization Form.)

Southeastern Spine will provide a thorough evaluation based on your symptoms, conditions and medical history. Bringing this information to your first appointment ensures that we can provide the best possible service during your first consultation.

Finding Us

Southeastern Spine is conveniently located at 2707 Citico Avenue, across from Memorial Hospital’s Doctor’s Building. Dr. Jolley provides comprehensive care for his long-time patients as well as his patient referrals.

For more information, driving Directions or to Schedule an Appointment, please Contact Us.

Surgery Preparation

*Please not that these are general guidelines meant to help you with any questions you may have prior to your surgery. Please contact Southeastern Spine with any questions prior to surgery.

Activity

Continue your current level of physical activity if possible.

Blood Products

Please notify your physician if you object to receiving blood products during your surgery at Southeastern Spine.

Dental Work

Any dental work should be completed at least four weeks prior to your surgery, or should be completed at least six months after your surgery at Southeastern Spine. Please contact Southeastern Spine if you have a dental emergency that falls within the time frame above.

Diet

Eat three balanced meals per day, including protein and calcium rich foods. Avoid high-sugar foods. Drink lots of fluids and add ample amounts of fruits and vegetables into your diet.

Female Patients

Prior to your surgery, please complete an annual pap smear and mammogram.

Illness

It’s important that you are at maximum health before major surgery. Always report any symptoms of illness such as temperature, cough, urinary infections, etc. to Southeastern Spine.

Medicines:

Avoid aspirin, Motrin, Advil, Indocin, Clinoril, Voltaren, etc, for 14 days (two weeks) prior to your surgery. Tylenol is acceptable. No herbal supplements 30 days prior to surgery.

Patient Forms

To learn more about becoming a patient at Southeastern Spine, please visit the Contact Us page, or Schedule An Appointment, today.