Active Life Orthotics, Prosthetics & Compression
  • COMPANY
  • Solutions
    • Prosthetic Services
    • Compression Solutions
    • Orthotic Devices
    • Pediatric Solutions
    • Cranial Remolding Helmets
    • Scoliosis >
      • Align
    • Post-Mastectomy Services
    • Wound Care
  • TELEHEALTH
  • COVID-19
  • RESOURCES
    • Patient Forms
    • Your Visit
    • Payments
    • Insurance
    • Referrals
  • LOCATIONS
  • COMPANY
  • Solutions
    • Prosthetic Services
    • Compression Solutions
    • Orthotic Devices
    • Pediatric Solutions
    • Cranial Remolding Helmets
    • Scoliosis >
      • Align
    • Post-Mastectomy Services
    • Wound Care
  • TELEHEALTH
  • COVID-19
  • RESOURCES
    • Patient Forms
    • Your Visit
    • Payments
    • Insurance
    • Referrals
  • LOCATIONS

REQUIRED PATIENT DOCUMENTS

All patients must acknowledge receipt of Active Life's HIPAA (privacy) policy.  Medicare beneficiaries also will be acknowledging receipt of current Medicare Supplier Standards.  Both documents are available as a viewable or downloadable PDF, and you may request a paper copy to be mailed to you.  Please contact our TeleHealth care team at TeleHealth@4activelife.com if you have any questions regarding completion of these forms.
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HIPAA Policy
MEDICARE SUPPLIER STANDARDS

PATIENT ACKNOWLEDGEMENT (E-SIGNATURE) 

SERVICES

Orthotics

Prosthetics

Compression

Pediatrics

Wound Care

Cranial Remolding Helmets

Scoliosis

Post-Mastectomy

LOCATIONS

Glendale, CA

Los Angeles, CA

Los Angeles, CA - Koreatown

Lakewood, CA - Long Beach

Northridge, CA

West Covina, CA

Orange, CA

Redlands, CA

Temecula, CA

San Diego, CA

GET IN TOUCH

info@4activelife.com

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