Thank you for choosing Orthopedic Institute of Pennsylvania. We want to make sure your visit is as smooth and convenient as possible.
To help us better serve you, please bring the following materials with you to your first appointment:
- List of questions for your physician
- List of symptoms
- List of all medications you are taking, including prescriptions and over-the-counter medicines
- Referral from your primary care physician, if required by your insurance company
- Any recent X-ray or MRI films related to your condition
- Any recent tests related to your condition
- Current insurance card or information related to an auto injury or workers’ compensation
- Photo ID, including a driver’s license or any other state or federal issued photo ID
- List of prior surgeries and medical history
Please visit our patient portal to fill out your history and general information. The forms below should be printed and filled out prior to your visit, if you are seeing one of the specific doctors listed below.
|Minor Policy and Authorization Packet||Minors (Parents please complete)|
|Authorization for Release of Medical Information||All Patients|
|Dr. Fernandez Spine Form||Dr. Fernandez’s Patients|
|Dr. DeLuca Hip Score Form 1||Dr. DeLuca’s Patients|
|Dr. DeLuca Hip Score Form 2||Dr. DeLuca’s Patients|
|Griffith – New Patient History Form||Dr. Griffith’s Patients|
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