patient
forms

For your convenience, this section of the Gavin Orthopaedics website contains some of our forms. Feel free to print them and fill them out prior to your visit to save you time upon your visit.

We recognize that a quality medical experience also requires excellent administrative support.

From the moment you enter Gavin Orthopaedics at the Sport and Spine Institute to the completion of your care, our staff will help you make appointments, answer all of your questions, help you understand your medical bill and insurance coverage, and provide other support you may need.

patient-form

FORMS

To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please print and complete these forms prior to your upcoming visit and bring them with you to our office at the time of your visit.

get-adobe-reader

NEW PATIENT FORMS

Download the new Patient Packet

Download, print out and fill the most appropriate form that pertains to your condition below, in addition to the above New Patient Packet. Please call us at 843-681-5077 if you have any questions.

Initial Visit Back Neck
Initial Visit Foot Ankle
Initial Visit Hand Wrist
Initial Visit Hip
Initial Visit Knee
Initial Visit Shoulder
Initial Visit All Others

FILL OUT AND FAX/EMAIL FORMS:

Fill out a form and Fax or Email it and your request will be processed within 24 hours, during normal business hours, Monday – Friday, 8:00 am – 4:00 PM, excluding holidays. If you do not receive confirmation of your request within 48 hours, please contact our office at 843-681-5077. Our Fax number is 843-681-5012.

REQUEST MEDICAL RECORDS/X-RAYS/MRI’S, ETC.

Please fill out the following form completely in order to request Medical Records, X-Ray or MRI images.  All requests will require an authorization to release Medical Records form completed.   Gavin Orthopaedics makes every effort to fill requests promptly, but we ask for at least a 48 hour business day window to fill your request.

Download form using the links below:

Medical Request Form

New Patient Forms

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New patient forms provide us with information about new patients including allergies, medications, family medical history, and more to help us asses your condition and make the best decisions for your care.

HIPAA

hipaa-compliant

The health insurance portability and accountability act provides federal protections for personal health information held by covered entities. Gavin Orthopaedics is HIPAA compliant.

Questions about forms? Give us a call

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Having problems deciding which form to fill out? We would be happy to answer your questions.

Give us a call at 843-681-5077