new patients

Specially for Our New Patients

Welcome! We would like to take this opportunity to welcome you to Empire Orthopedic Center and to thank you for choosing our practice.

We are constantly striving to make our patients' visits more efficient. We invite you to begin your new patient registration as soon as you'd like by downloading, printing, and completing your information on the following forms:

• HIPA - Notice of Health Information Practices

• Responsible Party/Insurance Information Form

• Medical History Form

A Checklist of To Do's

We have also included a checklist of information needed and will make the registration process easier for you and certainly more efficient.

1.Photo I.D. or drivers license

2.Insurance card

3.Referral form if applicable

4.X-Ray, MRI Films, CT Scans and EMG if applicable

5.If you have any lab results or other pertinent medical history information please bring that with you as well as this will help us serve you better.

Please Arrive Early

Please arrive 20 minutes before your scheduled time.

We Look Forward to Seeing You!

Thank you for your assistance in filling out this information and we look forward to seeing you on the day of your appointment.

- The Physicians and Staff of Empire Orthopedic Center

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