Bridgewater

I acknowledge that information submitted through this form will be sent via email, which is not a secure messaging system. Please refrain from sharing private health information here as we disclaim all warranties with respect to the privacy and confidentiality of any information submitted through this form. This form is for appointment requests only. To confirm your appointment, one of our patient access representatives will contact you for insurance details, coverage verification, and benefits discussion. No doctor's referral is needed for consultations or treatment. Please note we accept out-of-network payments from many commercial carriers, we are in-network with Medicare, and we do not accept Medicaid. By sharing your phone number, you agree to receive SMS from Performance Ortho. Standard rates apply. For data handling details, visit here. We do not share your mobile info with third parties, except for text messaging originator opt-in data, which remains confidential.*