Samotin Orthopaedics

Samotin Orthopaedics

Patient Forms

Download Patient Forms Below

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

Please printout and complete the appropriate forms:

Medical Information Sheet – Click here

New Patient Forms – Click here

Credit Card Financial Policy – Click here

Release of Records – Click here

Privacy Notice – Click here

What to Expect

​Please arrive 15 minutes early to your appointment in order to complete our new patient registration forms.

What should I bring to my appointment?

  • Your health insurance card(s)
  • A referral from your primary care physician if applicable
  • Your co-payment
  • Credit card/debit card
  • A list of your current medications
  • A copy of your x-rays, MRI, blood tests or any other diagnostic testing you have completed regarding the condition for which you will be treated.
  • ​A pair of shorts if you will be evaluated for a knee or hip condition
  • Our female patients are encouraged to bring a tank top if you are going to be evaluated for a shoulder injury/condition.​
  • If you are a minor (under the age of 18) you must be accompanied bya parent or guardian
  • What can I expect during my exam?
  • You will be escorted to an exam room by one of our medical professionals
  • Your medical history will be reviewed
  • Depending on the condition for which you will be treated, you may be required to have x-rays taken within our office
  • ​You will be examined by a physician or physician assistant where your course of treatment will be discussed.