Patient Forms
If you are a patient at Orthopedic Institute, please download, print, and complete the following forms and bring them with you to your appointment.
Medical Records Request
If you are a patient at Orthopedic Institute and would like your medical records sent to another facility, please fill out this online PDF form (Authorization for the Use or disclosure of Health Information). Once you complete the form, it will automatically send to our team and you will receive an email confirmation.
Consent for Treatment of a Minor
College students, athletes and other minors who come in for treatment without their parent/legal guardian need to have a permission form signed by their parent/legal guardian in order for us to provide treatment.
HIPAA Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully and retain a copy for your records.
Statement of Non-Discrimination and Languages
Orthopedic Institute complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
