No . Just let me see a doctor . I'm worried about my arm .   Be brave , sir . It won't be long . I will fill out the form for you . What is your name ?   Steve Schliessman . S C H L I E S S M A N .   Alright Steve . Your social security number ?   349-95- 8821 .   Do you have medical insurance ?   Yes , I do . Blue Cross .   Do you have your insurance card with you ? 