Tarun Bhargava, M.D.
Total Joint
Reconstruction of
Knees and Hips
and Fracture Care
Bradley W. Bruner, M.D.
Arthroscopic Knee
Surgery and
Sports Medicine
Phillip F. Hagan, M.D. Arthroscopic Knee
Surgery, Shoulder
Surgery, and
Sports Medicine
James Joseph, Jr., M.D.
Total Joint
Reconstruction of
Knees and Hips
Duane A. Murphy, M.D.
 Emeritus

REQUIRED PAPERWORK FOR AN APPOINTMENT

All Orthopaedic & Sports Medicine patients are required to fill out the following forms. All patient forms are now available online and can be filled out at your convenience. If you complete these forms online, you do not need to fill out the printed forms and bring them into the office.

Click the "Start Online Forms" button to start filling out the patient forms online. If you are a registered user, please click on the "Registered User Login" button to access your account.


Patient Information Online Form or Printable Form
     - Patient Information Form to be filled out for your first visit to Orthopaedic & Sports Medicine

Patient History Online Form or Printable Form
     - Patient Medical History Form to be filled out for your first visit to Orthopaedic & Sports Medicine

Patient Current Medications, Allergies, and Surgeries Form or Printable Form
     -  Patient Current Medications, Allergies, and Surgeries Form to be filled out for your first visit to Orthopaedic & Sports Medicine

Billing Policy Online Form or Printable Form
     - Billing policy for HMOs, PPOs, and Managed Care Programs

Permission to Release Information Online Form or Printable Form
     -  Permission to Release Medical and/or Financial Information to A Specified Party
NOTE: Only patients over the age of eighteen are required to fill out this form.

HIPAA Privacy Policy Online Form or Printable Form
     - Acknowledgement of Receipt of HIPAA Privacy Notice

Controlled Substance Medication Agreement or Printable Form
     - Controlled Substance Medication Agreement


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