PATIENT FORMS

Thank you for choosing Hope Orthopedics for your orthopedic care.

To save time you may download, print and complete our required patient forms. Please remember to bring your completed forms, along with the following pieces of information to your scheduled appointment. If you do not complete these forms you will be able to complete them on our electronic check in station or on a paper copy when you arrive at our office.

 

Don' t forget to bring the following with you to your appointment:

  • Photo ID
  • Insurance Card
  • Referrals (If required by your insurance)
  • Co-Payments (If required by your insurance)

Forms

Please use the links below to download our patient forms.

 

Authorization for Verbal Communication of Protected Health Information to Family or Friends

Billing Information Form

Consent to Treatment for Minors Authorization Form

Medical Information Disclosure Authorization

Neuro Health History (for Neuro Patients Only)

Notice of Privacy Practices

Notice of Privacy Practices Spanish

Orthopedic Health History

 

Please feel free to contact us at 503-540-6300 if you have any questions.