Patient Info

August 30, 2016

Our goal is to make your relationship with us, however brief or long it may be, a positive, pleasant and healing experience. We encourage you to ask questions of any of us about anything you don’t understand or feel uncomfortable with concerning your treatment or procedure, or about our privacy policies, billing process, insurance coverage or any other aspect of your care at Hughston Orthopaedic Clinic.


Appointments: Although many patients come to Hughston Orthopaedic Clinic through a referral from another physician, this is not a requirement. You may make an appointment to see most of our doctors without a referral. Online requests for appointments are available or call toll free at 800-331-2910. You may also call the Hughston Clinic satellite office in your area. Click here for a list of our locations. Appointments should be made at least two weeks in advance. If you must cancel an appointment, please notify our office as soon as possible.


Payment: Because statements and billing have become so expensive and because we do our best to keep all medical costs down, we ask that you pay any balance and copayments at check-in. We accept cash, personal checks, VISA, Discover Card, or Master Card. Our staff will file your insurance claims at no charge. Please have your insurance information available when you come for a visit and keep copies of all billing information so you can follow up on claims with your insurance company if necessary. When your visit is complete, a medical assistant will escort you to the check-out desk to schedule follow up appointments if necessary.


Refills: We try to process your request for prescription refills as quickly as possible. When you need a prescription refill, please notify your pharmacist or call our office. Calls received after 2:30 p.m. for routine refills will be handled on the next business day. Please call before noon, if possible, to ensure same day response. During evenings, weekends, and holidays, the doctor on call does not have immediate access to your records, so routine prescriptions cannot be refilled during this time.


Patient Forms

Retrieval For Medical Records
Print and complete this form for release of medical information.
Subrogation Form
Print and complete this form if your injury was a result of an accident.

TPL Form
Print and complete this Tricare form if there is a third party liability.


Hughston Clinic South East, P.C., P.A.                      Discrimination Form

Hughston Clinic, P.C.                                                     Discrimination Form

Hughston Clinic,  P.C., P.A.                                          Discrimination Form

Jack Hughston Memorial Hospital                             Discrimination Form

Hughston Clinic Orthopaedics – Tennessee              Discrimination Form


Patient Education Videos





HIPAA Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you may get access to this information. Please review it carefully.

Hughston Clinic is dedicated to protecting your medical information. We are required by law to maintain the privacy of protected information and to provide you with this notice of our legal duties and privacy practices with respect to protected health information. Hughston Clinic is required by law to abide by the terms of this notice.
How your medical information will be used and disclosed:
We will use your medical information as part of rendering patient care. For example, by the doctor or nurse treating you, by the business office to process your payment for the services rendered and by administrative personnel reviewing the quality of the care you receive may use your medical information.
We may also use and/or disclose your information in accordance with federal and state law without your consent for the following purposes:


  • Appointment Reminders — May contact you to provide appointment reminders
  • Treatment Information — Other alternative treatments or health-related services that may be of interest to you
  • Law Enforcement — May disclose your information as required during as investigation
  • Legal Proceedings — May disclose your information in the course of certain judicial or administrative proceedings
  • Public Safety — May disclose your information to prevent or lessen serious threat to the health or safety to the public
  • Military Activity and National Security — May disclose information to military command for their military records or other federal officials conducting national security and intelligence activities for protective services for the President
  • Workers Compensation — May disclose information as authorized to workers compensation or similar programs
  • Inmates — May disclose information to the correctional facility or law enforcement official for your proper care
  • Abuse or Neglect — May disclose information when it concerns abuse, neglect or violence in accordance to federal or state law
  • Coroner Medical Examiner, or Funeral Director — May disclose information for identification of a body or to determine cause of death
  • Food and Drug Administration — May disclose information to report adverse events, product recalls to make repairs or replacements
  • Research — May disclose information for certain research purposes if an Institutional Review Board has reviewed the research proposal and established protocols to ensure the privacy of your information {GA Code Ann. 31-7-6(b)}
  • Disclosure to Department of Health and Human Services — May disclose information for public health purposes to help control disease, injury or disability, also to a person who may have been exposed to a communicable disease or at risk of contacting or spreading a disease or condition
  • Others Involved in Your Healthcare — May disclose information to a family member, other relatives, close personal friends or other representative you authorize when medical information is directly relevant to that persons involvement in your care
  • Health Oversight Activities — May disclose information for activities authorized by law, such as audits, investigations and inspections. Oversight agencies seeking this information include government agencies that oversee health care systems, government benefit programs and other government regulatory programs and civil rights law
  • Disaster Relief — May disclose information to a public entity, such as the American Red Cross, for purpose of coordinating with that entity to assist in disaster relief efforts
  • Facility Directory — Unless you object, we will use and disclose in our facility directory your name, and the location at which you are receiving care. This information will be disclosed only when someone calls and asks for you by name
  • Business Associates — May disclose information to a business associate that we have a contract with to provide services on our behalf. We require our business associates to appropriately safeguard the health information of our patients.

We will not use or disclose your medical information for any purpose without your written authorization. Once given, you may revoke your authorization in writing at any time.


To request a Revocation of Authorization form, you may contact:
Your Personal Provider (Physician)
Hughston Clinic
6262 Veterans Parkway

Columbus, GA 31908