Orthopedic Care for your entire family

Maximum mobility — Minimum down time
Instructions
  1. Fill out the forms
  2. Print
  3. Sign & Date
  4. Either fax them to 503.238.0873
    OR bring them in on your next visit.

Anything that you have questions on just ask during your next visit or call 503.234.9861 and our office staff will gladly assist you.

Due to the personal confidential information that is collected on these forms, please do NOT attempt to email them back to us. Fax them or bring them in personally.

We hope that having these forms accessible online makes things more convienient and saves you time!

- Orthopedic Specialists, P.C.
Home > Forms

To save yourself time at the waiting room, download and fill out these forms at home.
You will need Adobe Reader to view and fill out the files, you can get it here: http://www.adobe.com/products/acrobat/readstep2.html

Generic Forms
   Medical History Questionaire
   Orthopedic Specialists Registration Form

Doctor Specific Forms
   Dr. Button's Spine Patient History Form
   Dr. Wagner's Medical History Questionaire

HIPAA & RED FLAG Rule
OSPC is now required by the Federal Trade Commission to show a copy of a valid Photo ID from each patient or patient's guardian presenting to our office.

If you are unable to provide a valid Photo ID, OSPC cannot bill your insurance company, and you will have to pay for your visit at the time of service.

   Red Flag Notice
   Red Flag FAQ
   Authorization Form
   OSPC Privacy Notice
   Privacy Notice Acknowledgement


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