Registration Forms
Let us help you prepare for your first visit to Louisville Orthopedic Clinic
We have prepared this booklet to introduce you to our office and to provide you with important information regarding our office policies and medical practices. If you have any questions not answered by this booklet, please feel free to call our office or ask a staff member at your next visit.
We have also created PDF versions of the check in paperwork you can print off at home and complete before you come to the office.
Click here to download the Registration Packet combines all the forms you need to complete before your visit, or fill out your registration forms online.
- Patient Registration (please complete all questions)
- Patient Medical History
- Allergies and Current Medication
- HIPPA Authorization Form
- Authorization for Use or Disclosure
HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA), was the result of efforts by congressional healthcare reform proponents to reform healthcare. The goals and objectives of this legislation are to streamline industry inefficiencies, reduce paperwork, make it easier to detect and prosecute fraud and abuse and enable workers of all professions to change jobs, even if they (or family members) had pre-existing medical conditions.
Notice of Privacy Practices
Medical Records Release
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| KNEE | HIP | SHOULDER | ANKLE/FOOT | SPINE |
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