Forms & Records

New Patient Forms

To save time, you may print and complete these forms, and bring them with you to your first visit.

To view these PDF forms you'll need the freely available Adobe Reader software installed on your computer.

Your web browser may be configured with an Adobe Reader plug-in to automatically open the file within your browser's window when accessed. We recommend that you save the PDF file to your computer and access the file locally by opening Acrobat Reader. To download the file directly to your local drive, right click on the link then select "Save Target/Link As..." from the menu. Use Adobe Reader to open the file. To use the online editing feature with documents (as noted below), you will need version 8.16 or higher.

Medical History - Printable PDF - you may print this form for completion if you have any version of Adobe Acrobat.
Medical History - Editable PDF - if you have version 8.16 or higher of Adobe Acrobat, you may save this file, edit and print.
Notice to Consumers: Medical Board of California - print and sign.
Welcome to Our Practice - for your review only (no signature required)
Notice of Privacy Practices - for your review only (no signature required)
Receipt of Privacy Notice - print and sign
Records Release - if you will be giving someone else permission to receive/review your medical records on your behalf, please print and sign

Office Policy for Filling out Forms

Please allow 48 hours for all forms to be completed. We will strive to do this in a shorter time frame but that is not always possible.
We would be happy to fax out forms, mail them to you, or arrange for pickup, whichever you wish.
There is a nominal $5.00 charge to fill out disability forms.
If you would like us to mail out forms directly for you, please make sure they are signed, completed and dated in advance.
For disability papers involving surgery, forms will be filled out after the procedure. Surgery procedure codes are required and these are not always known until the operation is completed.

Medical Records

Please allow 48 to 72 hours for chart copies. There's a $15 charge for the copying of medical records.
If we are referring you to another physician, there will be no charge for copying or mailing of your medical records.

X-rays, MRIs, etc.

Radiographic studies are part of your legal medical record. We would be happy to sign your films out to you, but we respectfully request that you return them in a timely fashion.
Copies may be requested. Please allow approximately 1 week for copies to be made. There may be a small nominal charge based on the number and the size of the films. Unfortunately, at this time we are unable to make copies of outside films.

Thank you for taking time out of your busy schedule to review these policies and procedures. We look forward to the opportunity to serve all your orthopaedic needs!