- If you are paying by Credit Card, you must follow the link that will be provided after you submit this form.
- If paying by check, please make check payable to "Reconstructive Orthopaedic Associates" and mail to:
925 Chestnut St., 5th Floor
Philadelphia, PA 19107
Please include in the check memo "Disability Forms" and your account number, if known
PLEASE ALLOW 7 – 10 BUSINESS DAYS FOR PROCESSING AFTER PAYMENT IS RECEIVED.