For State Farm please use the following forms



All TeleEMC State Farm patients are now being referred to Reiter Ortho (https://reiterortho.com).

Reiter Ortho staff is available to assist you, and your patients in completing required documentation, or connecting with Reiter Ortho‘s physicians via telemedicine on the Doxy.me platform. Progress notes will be sent to your office immediately, as you have been accustomed to.

If you need any further assistance please contact Reiter Ortho at (561) 346-7415 and reference that you are calling about an EMC.

Download Forms

PIP EMC Form
Download printable PDF of the paperwork (Español | Kreyol )

Online Forms

EMC Registration FormReiter Ortho New Patient Packet online (Español | Kreyol)

Minor Consent

EMC Form
Click for Minor Children EMC Patient Form