Patient Forms

Guardian Permission to Treat

OAA Orthopaedic Specialists must receive permission from a child’s parent or legal guardian before providing treatments for an injury or illness that is non-life threatening. This form gives us legal permission to treat your child in case you cannot accompany him/her to the office for treatment.  If the party accompanying your child (baby-sitter, friend, relative, etc.) does not present this information, the clinic will attempt to contact you to request permission to treat your child.
Guardian Permission to Treat

Patient Request for Confidential Information (HIPAA)

The OAA Patient Request for Confidential Information (HIPAA) form serves as a request for confidential communication of one’s protected health information (PHI). Please complete this form only after reading the HIPAA Notice of Privacy Practicefor OAA Orthopaedic Specialists This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

Release of Medical Records

This form enables you to retrieve copies of your medical records if necessary. Please read each description carefully to be sure you are accessing the appropriate form.

• In order for OAA to send a copy of your medical records to you or another physician(s), you are required to complete the following form (only one copy is necessary): OAA Release of Medical Information Form From OAA
• In order for OAA to receive a copy of your medical records from another practice or physician(s), you may be required to complete the following form (only one copy is necessary): OAA Release of Medical Information Form To OAA

You may print, complete, and return the appropriate form via either:
U.S. Mail: 250 Cetronia Road, Allentown, PA 18104, Attn: Medical Records
Fax: 866.644.0894
Drop-Off: OAA Check-in Desk, 250 Cetronia Road, 2nd Floor

Note: All records requests will take approximately 5 business days to process