Below, please find PDFs of a variety of patient information forms. Please print out and complete any form applicable, or as directed prior to your next appointment.

Patient Forms – Orthopedic

Form A – New Patient Registration Form

Form B – Patient Post-Op/Fracture Care/Injection Form

Patient Forms – Pain Management

Form C – Pain Management, Patient Registration New Patient Form

Form D – Pain Management Follow Up/Post Injection

Patient Forms—Medical Records

Form E – Medical Records Release Form

Form F – Addendum Request Form

What Our Patients Are Saying

View All Testimonials learn-more-arrow
  • "For several years, I have been seeing Dr. Robert Lippe at the Orlin & Cohen office in Massapequa ...

    Clare McCarthy

    Massapequa, Merrick

    Procedure

    Pain Management

    Performed By

    Robert J. Lippe, M.D.,Joseph A. Cardinale, M.D.

  • "When my son Brett tore his ACL and a double tear of the menicus, I felt that it hit me worse than it ...

    Brett Williamson

    Procedure

    ACL Surgery

    Performed By

    Ryan Krochak, M.D.

  • "Recently, I underwent surgery with Dr. Lieberman to repair a torn rotator cuff of my right shoulder. ...

    John Fleitman

    Bohemia

    Procedure

    Rotator Cuff Surgery

    Performed By

    Gregory Lieberman, M.D.

New
Appointment
Follow-Up
Appointment
Hero Shape

Request an Appointment

Our offices across Long Island are open for in-person visits with new protocols for immediate, personalized care in the safest possible environment.  Learn more.
To schedule a new in-office or telehealth appointment, please fill out the form below. We will respond as quickly as possible. To request a follow-up appointment, click here.

* Required Fields