Patient Forms

At Youngstown Orthopaedic Associates, we are continually striving to improve your experience when visiting our practice. To facilitate this, we ask that you complete your required paperwork (which has been mailed) and return it to our office (5) days before your scheduled appointment by mailer or faxing to 330-729-2758; this paperwork includes HIPAA, Medical History Information, Demographics, and our Financial Policy. On the day of your appointment you will need to bring your driver's license and insurance card.

If you have not received this paperwork, you are able to download by clicking the links noted below and bring the completed and signed paperwork to your scheduled appointment.

You will need to bring: 1) Signed Privacy Practices (HIPAA) Consent Form; 2) A Completed Demographics Form; 3) A Signed Financial Policy; and 4) A Completed Patient Medical History Form specific to the physician you will be seeing.

Please take time to review the forms and sign in the appropriate areas.

Patient Medical Forms

Online Patient Registration Form

Click on this link to access a secure web form version of the required patient medical history paperwork. We created this online option for your convenience and ease of use. You will receive a confirmation upon successfully submitting the form to Youngstown Orthopaedic Associates.

Forms - General Paperwork

Patient Medical History Form - General