Forms

Please complete the HIPAA Form, Demographic, and Statement of Financial Responsibility prior to your visit.

Spine and Pain Management Patients please also complete the Pain Questionnaire prior to your visit.

You may fill it in online then print your completed forms or print and complete them by hand and bring them along with you to your appointment.

You may open the forms below, fill it in online then print your completed form, or print and complete them by hand and bring them along with you to your appointment.

• HIPAA Form
• Pain Questionnaire (for Spine and Pain Management Patients)
• Demographics
• Statement of Financial Responsibility

Medical Records Release forms:

An authorization form is required when requesting  for copies of medical records. Please complete the medical records release form below and return to SportsMED, or email the completed form to [email protected].

• SportsMED Medical Release Form