Patient Resources

Patient Disability Forms

PLEASE NOTE:  There is a $20.00 processing fee for new form(s).  Please note fee schedule for processing fee of other forms.  In order to have your form(s) processed, pre-payment is required.  AOC will make every effort to quickly process and return your form(s) to you.

WANT TO GET YOUR FORMS COMPLETED FASTER?

Completing the online form and submitting your disability form(s) online will greatly speed up the process of getting your forms returned to you.  There is no need to drive to AOC when you can simply upload your form and submit it for processing.  Once your form is received, an AOC staff member will call you to receive payment.  Once payment is received, your forms will be processed.

Please note that patients will receive two text messages from AOC.  The first will let you know that the disability form(s) have been logged into the system.  The second text message will let you know the form(s) is completed.  There is no need to call and check on the progress.  We will keep you updated.

If you have any questions about your forms, please contact laurice_quillings@alortho.com.  If you have any problem uploading your form(s), please fax them to (251) 410-3752.

File upload directions

First Name*

Last Name*

Phone*

Email*

Date of Birth*

Select Form Type: *

Upload your Disability Form Here: *

Comments