Patient Forms
To make your experience with Advanced Orthopaedics more convenient and enjoyable, we provide the ability to download office forms, make an appointment, refill a prescription and more--any time of day, directly from your computer.
Online Forms
Printable Forms
Patient Intake Form
 Patient Intake Form - Dr. Bacon
Initial Visit Forms
If this is your first visit with Advanced Orthopaedics, you can save time in the waiting room by downloading our initial visit forms and filling them out before your appointment. Click on the appropriate form(s) below, print out the form(s) and give the completed form(s) to the receptionist at your first visit.
Note that there are four Patient History forms available. One is a general form that will be used by most patients. There are also one each for patients who will be seeing Dr. Cubbage, Dr. McChesney, or Dr. Bacon. Please be sure to fill out the correct form. If you do not know which form(s) to complete, please call us prior to your appointment.
You may also download our Patient Financial Policy Sheet to sign and bring with you to your first appointment to further save time in the waiting room.
American Recovery Act & Additional Information requested from Patients
HIPAA Consent Form
General Patient History
Patient History - Dr. Cubbage
Patient History - Dr. McChesney
Patient Financial Policy Sheet
Record Release Forms
For the convenience of our current and former patients, we provide the ability to download forms you can use to request your Advanced Orthopaedics medical records and x-rays.
Simply click on Download PDF next to the form(s) you need, print and complete the form(s), and mail or fax your request to the appropriate office. Our office addresses and fax numbers are printed on the forms.
Medical Records Release
You will need to have the FREE Adobe Acrobat Reader installed on your system to view this document. Download the Reader by clicking on the Acrobat icon below.
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