Patient Forms/Registration

Patient Registration Forms

New patients are asked to contact our office at (330) 758-0577 to secure forms that can be filled out prior to your visit. If you’re already a patient and need to complete forms prior to your appointment, you can visit our patient portal.

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 and send it to us at least five days prior to your scheduled visit.

We will require:

1) A completed Demographics form;

2) Your complete Patient Medical History form

3) A signed Privacy Practices (HIPAA) Consent Form, and

4) A signed Financial Policy.

The Demographics and Patient Medical History forms can be completed using the Online Patient Registration Form.

A combined Privacy Practices and Financial Policy form will be presented to you upon your visit for signature.