Patient Forms

Thank you for choosing The Orthopaedic Group, P.C., for your orthopaedic care. For your convenience, you may download, print, and complete our required patient forms below. Please remember to bring your completed forms, along with the following pieces of information, to your scheduled appointment:

  • Insurance Card
  • Photo ID
  • Referrals (If required by your insurance)
  • Co-Payments (If required by your insurance)

Please use the links below to download and print our patient forms.

Alabama High School Physical Form

General Patient Forms for all Doctors:

New Patient History Questionnaires (PDF)

New Complaint Questionnaire for New and Existing Patients (PDF)

Demographics Form (PDF)

HIPAA Privacy Form

Financial Responsibility Form

Consent for Treatment Minor Child (PDF)

Insurance & Billing Forms

Patient Instruction Form

Patient Authorization Form

Additional Patient Forms for Spine Doctors:

  • James L. West, III, M.D.
  • Todd K. Volkman, M.D.
  • Bendt P. Petersen, III, M.D.
  • Clinton W. Howard, IV, M.D.
  • Chris T. Nichols, M.D.

Spine Form (PDF)

Scoliosis Form (PDF)

The latest version of Adobe Acrobat Reader is required to view and print PDF files, and it is available here.