New Patients

As a new patient of Arlington Orthopedic Associates, you will be asked to complete the following forms and bring to your initial appointment. If you prefer, you may fill in the needed information, print the form and fax to: 817-299-1735.

Required forms:

Patient Information Sheet

Review Of Systems Form

Notice of Privacy Practices Form

AOA Financial Policy Form

Please also complete one of the following forms:

General Form

Knee Form

Shoulder Form

Authorization forms:

Authorization for Minor form

Authorization to release PHI to Family members form

Medical Record Release

To request a copy of your medical records, please print this form and fax to Arlington Orthopedic Associates at 817-299-1715. Please allow 5-7 business days to process.

If you need a CD of your X-rays or MRIs, please check the appropriate box – X-ray CD and/or MRI CD.

Authorization for Release of Medical Records