For your safety, we have streamlined your check in process and there is no longer a need for paperwork.

Orthopedic Medical Records

Form E – Medical Records Release Form

Form F – Addendum Request Form

MRI Forms

MRI Pregnancy Consent

Gadolinium Consent

CT Questionnaire

Companion Questionnaire

MRI Screening Questionnaire

Physical Therapy Forms

Commercial New Patient

MCR New Patient

No Fault New Patient

Self Pay New Patient

WC New Patient

How we helped our patients feel better.

  • Steve Kurtis
    "While vacationing in the Adirondacks, I suffered a nasty fall in the woods that severely damaged my right ...

    Steve Kurtis

    Procedure

    Shoulder Surgery

    Performed By

    Eric P. Keefer, M.D.

  • Don Phillips
    "I'm a professional speed skater and the pain of osteoarthritis almost forced me to hang up my blades ...

    Don Phillips

    Procedure

    Hip Replacement

    Performed By

    James A. Germano, M.D.

  • Bibi Yaseen
    "I started seeing Dr. Mait in February. The instant I met him, I knew he was going to be such a easy and ...

    Bibi Yaseen

    Procedure

    Fractured left foot and knee

    Performed By

    Jeffrey E. Mait, M.D.

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