Patient Forms


 

Patient Portal

Patient Portal

 

Patient Forms

Town Center Orthopaedic Associates, P.C. HIPAA Notice of Privacy – Town Center Orthopaedic Associates, P.C. Notice of Privacy Practices (NPP)

Town Center Orthopaedic Associates, P.C. HIPAA Prácticas respecto de la privacidad – Town Center Orthopaedic Associates, P.C. Aviso acerca de las prácticas respecto de la privacidad (NPP, en inglés)

 

Medical/Legal

Please allow up to 7 - 10 business days for your Medical Records request to be completed.

Authorization for Release of Medical Information– Please fill out this form for authorization to release your medical information.

Electronic Record Delivery Request – Please fill out this form to receive your medical records via email through a secured site.

Outside Records Delivery Request– Please fill out this form to have outside records released and delivered to TCOA.

Please email your completed forms, or if you would like to know the current status of your forms that have been previously submitted, to our Medical Legal Department here.

Our Locations

Choose your preferred location