Release of Information
Thank you for contacting the WEST TENNESSEE BONE AND JOINT Release of Information Department. We are here to serve you and your health information needs.
For FMLA or disability leave paperwork, please complete the form below.
- Please make sure you have specific instructions included as to where you are requesting the Form to be sent after completion.
- Leave will only be certified based on your treatment plan while under the care of WEST TENNESSEE BONE AND JOINT.
- You may elect to have completed Form emailed, mailed, or faxed to the recipient listed. It is recommended that you elect to receive your Form back via email.
- Please be aware that you are authorizing the release of protected health information to supplement your FMLA/disability leave claim. This means records may be attached to the Form that are being completed and will be released as indicated on the authorization.
A fee of $15.00 per form is required prior to form completion. You will be contacted by Sharecare with payment options after you return this paperwork to your provider. Once payment is received, your form will be completed and sent to the recipient listed on your release. For questions pertaining to FMLA or disability leave paperwork, please contact Sharecare at 866-273-4039.
Form Completion Process FAQ
The FAQ will help guide you through your FM LA/Disability or accident claim.
Do I need to sign an authorization form even if I want the form sent back to me?
Yes, we would like all the patients to fill out a Request for Form Completion document when requesting a form to be completed. This document provides the team with information on where and how to send the form. Also, if a disability insurance company calls, we cannot give any information without consent, thus delaying your claim with your disability company. In addition, this document asks for the patient to identify the treating provider, injury/problem date, and last day worked, which will aid in completing your form.
I do not use email or know my Request ID number. How can I get status updates on the completion of my form?
You can contact the Sharecare Forms Department at 866-273-4039 for the status of your form, as well as the Request ID number associated with your form.
I need to update the information on my FMLA or Disability paperwork. What do I need to do?
We understand that FMLA forms, as well as disability determinations, may require an update of your medical information from your recent doctors’ visit. You will need to re-submit the new paperwork to West Tennessee Bone and Joint for Sharecare to complete in such cases. There will be a fee of $15.00 required for any updates requested.
When will I receive my completed forms?
Please allow 48 hours for Sharecare to receive your form from the time you submit it to West Tennessee Bone and Joint. Once payment is received, it may take up to 5-7 business days to complete the forms. It is imperative to submit all information and make the pre-payment as soon as possible; failure to do so will delay the process.
I submitted my paperwork but no longer need it to be completed. How can I cancel it?
You can contact the Sharecare Forms Department at 866-273-4039 for assistance.
I still have questions?
Please reach out to our team at Sharecare, and we are happy to discuss any questions you might have. Contact us at 866-273-4039.