Patient Forms

Download, print and complete the forms specific to your doctor prior to your first visit.

For your convenience, we have patient registration forms also available on our patient portal for completion prior to your visit.

New Patient Forms
Spine Center New Patient Forms - Dr. Lavoie and Nick
Dr. Waldbaum New Patient/New Problem Forms
Dr. Waldbaum Patient Follow Up Forms

Medical Records Upload

Please understand that uploading medical records may be a lengthy process depending on the size of the file and your internet connection. Please be patient during the upload process. A confirmation will appear along with a tracking number once the file has been received. Please refrain from hitting the upload buttons multiple times. This can/will result in the records failing to upload and could lock you out of the system.

Please use the link below to upload information securely to our practice.

Medical Records Upload for Patients

Remember to bring the following items:

  • X-ray, MRI, EMG or other studies
  • Operative reports
  • Diagnostic test results
  • Insurance information
  • Current list of medicines or Ziploc bag of medicines
  • Photo identification

Release of Health Information

Florida Orthopaedic Associates has partnered with Sharecare to fulfill your requests for records.

Florida Orthopaedic Associates is committed to protecting your medical information. For information about your rights and the obligations you have regarding the use and disclosure of your medical information, please see our Notice of Privacy Practices.

If you are our patient and would like to request your medical records, please click on the link below to complete your request for medical records. You will be required to provide a valid email address and a government-issued ID.

Click Here to Submit an Online Request for Medical Records

 

If you are unable to complete the electronic form above, download and complete the paper form below. The authorization form must be legible and complete. Authorizations that are illegible or incomplete will be returned. Please note the processing of records is faster using the online form above.

Records are usually available within 10 days from the time the request is received. If you are picking up your medical records in person, please be sure to bring a government-issued ID. To arrange for another individual to pick up the documents for you, please indicate that on the authorization form, and ask them to bring their government-issued ID.

Only the patient, parent/legal guardian, or the patient’s legal health care representative can sign the form to release medical records. If you are requesting records on behalf of the patient or as the patient’s representative, please provide a copy of an Advance Directive/Durable Power of Attorney for healthcare/ Conservatorship.

Paper Form – Authorization to Use and/or Disclose Medical Records

 

When will my online medical record request be ready?

Your records will be ready in 10-14 business days from the receipt of your electronic request.

How do I check the status of my request?

Go to https://recordstatus.sharecare.com

How do I pay for my records and/or radiology images?

Go to: https://payonline.hds.sharecare.com/

How do I contact Customer Service?

You may call: 858-244-1811 or Contact Support for live chat: https://hds.sharecare.com/contact-us/