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 came into physical therapy not even sure what was wrong with my hip and a little hope to play in my ...

Chris O’Mara

Procedure

Hip/Groin physical therapy

Performed By

Read Review
"My experience with the Orlin and Cohen group to strengthen my shoulder has been phenomenal. Kudos first ...

Leah Watson

Procedure

Shoulder Physical Therapy

Performed By

Alpesh Shah, M.D.

Read Review
"Dr. Gerber did a superb job of replacing my hips and knee. I haven’t felt this good in years. There ...

Starr Schamis

Procedure

Hip and Knee Replacements

Performed By

Bradley Gerber, 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.

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

Request an Appointment

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

* Required Fields