Patient Forms | Orlin & Cohen Orthopedic Group | LI Orthopedics

New Patient Form

New Patient Packet

Orthopedic Medical Records

Form E – Medical Records Release Form

Form F – Addendum Request Form

MRI Forms

MRI Safety Screening Form

Neuropsychology Paperwork

Adult Neuropsychology Intake Form

Child & Adolescent Neuropsychology Intake Form

Physical and Occupational Therapy Forms

PT & OT Patient Intake Form

Northwell Notice of Privacy Practices

Consent for Minors to be Treated Without Parent Present

How we helped our patients feel better.

Read Patient Reviews

Share Your Story

"I sprained my ankles numerous times playing soccer and in 2007 had a lateral reconstruction and microfracture ...

Paul D.

Long Island, NY

Procedure

Stem Cell Therapy

Performed By

David I. Zaret, M.D., M.B.A.

Read Review
"I had the most amazing professional occupational therapist. Her name is Briana. She did an excellent ...

Priya Kalukeerthie

Procedure

Wrist Fracture

Performed By

Read Review
"When I found out that I was going to be needing ACL surgery, I was crushed. I was apprehensive about ...

Emma Schait

Procedure

ACL Repair

Performed By

James Paci, M.D.

Read Review

Hero Shape

Request an Appointment

To schedule a new in-office or telehealth appointment, please fill out the form below. We will respond as quickly as possible.

Request an Appointment

First Name * Required
Last Name * Required
Email * Required
Phone * Required
Appointment Type
Pain Management Physicians * Required
Pain Management Locations * Required
Preferred Doctor
Preferred Physical or Occupational Therapist
Preferred Location * Required
Reason for Visit * Required
Captcha

Email
This field is for validation purposes and should be left unchanged.

gform 2 Submit

* Required Fields