New Patient Forms

		Rosemary Buckle, M.D. Orthopaedic Surgeon New patient form packet			Vivek P. Kushwaha, M.D. Orthopaedic Surgeon, Specializing in Adult Lumbar and Cervical Disorders & Spine Trauma New patient form packet
		Allen R. Criswell, M.D. Orthopaedic Surgeon New patient form packet			Alan J. Rechter, M.D. Orthopaedic Surgeon New patient form packet
		Gregory P. Harvey, M.D. Orthopaedic Surgeon Sports Medicine New patient form packet			Navin Subramanian, M.D. Orthopaedic Surgeon, Specializing in Adult Lumbar and Cervical Disorders & Spine Trauma New patient form packet

Click to download the New Patient Form packets to prepare early for your appointment with your doctor.

Patient’s Rights

A patient has the right to be treated with courtesy and respect, with appreciation of his/her individual dignity, and with protection of his/her need for privacy.

A patient has the right to know who is providing medical services and who is responsible for his/her care.

A patient has the right to be given by his/her health care provider, information concerning diagnosis, planned course treatment, alternatives, risks and prognosis.

A patient has the right to receive a copy of a reasonably clear and understandable, itemized bill and upon request, to have the charges explained.

A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, physical handicap or source of payment.

A patient has the right to know if medical treatment is for purpose of experimental research and to give his/her consent or refusal to participate in such experimental research.

A patient has the right to confidential handling of medical records and, except when required by law, patients are given the opportunity to approve or refuse their release.

Patient’s Responsibility

A patient is responsible for providing to his/her health care provider, to the best of his/her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications and other matters related to his/her health.

A patient is responsible for reporting unexpected changes in his/her condition to his/her health care provider.

A patient is responsible for reporting to his/her health care provider whether he/she comprehends a contemplated course of action and what is expected of him/her.

A patient is responsible for following the treatment plan recommended by his/her health care provider.

A patient is responsible for keeping appointments and, when he/she is unable to do so for any reason, for notifying the health care provider or health care facility. Failure to do so will result in a $25.00 charge to your account. Patients should notify Orthopaedic Associates within 24 hours of their appointment if there is a need to reschedule/cancel.

A patient is responsible for his/her actions if he/she refuses treatment or does not follow the health care provider’s instructions.

A patient is responsible for assuring that the financial obligations of his/her health care are fulfilled as promptly as possible.

A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.

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