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Advanced Orthopedics New England
  • Home
  • About
    • Reviews
  • Meet Our Specialists
    • Dr. Allen Berkowitz
    • Dr. Scott Bissell
    • Dr. Amanda Fantry
    • Dr. Matthew Grosso
    • Dr. Jay Kimmel
    • Dr. David Kruger
    • Dr. Daryle Ruark
    • Dr. Steven F. Schutzer
    • Dr. Brett Wasserlauf
    • Advanced Practice Providers
  • Conditions We Treat
    • Neck & Back
    • Shoulder
    • Hand, Wrist & Elbow
    • Hip & Knee
    • Foot & Ankle
  • Services
    • Orthopedic Urgent Care
    • Workers Compensation
    • Joint Replacement
    • Sports Injuries
    • Trauma & Fractures
  • Patient Info
    • General Information
    • Patient Forms
    • Patient Education
  • Contact & Locations
    • Bloomfield
    • Enfield – Urgent Care
    • Rocky Hill
    • Vernon – Urgent Care
    • Springfield, MA

Patient Forms

To accept a new patient at Advanced Orthopedics New England, we must collect a significant amount of information from you.

We ask you  to fill out forms about personal identification, insurance, medical history, and your specific injury or problem. We understand that this is time-consuming and sometimes cumbersome. However, the information you provide is vital for the diagnostic process. Without it, our providers are unable to arrive at the proper diagnosis and treatment plan.

The information you provide is also necessary to bill your insurance for the services we provide. We will mail or fax the required forms to you ahead of time, or you can use this website to download the appropriate forms for your physician This way, you can have them completed when you arrive for your appointment.

Choose your care team to download the necessary forms

  • Dr. Allen Berkowitz and Michael Harris, PA-C

    • New Patient Forms
      • New Patient Packet (Printable Version)
      • New Patient Demographics (Interactive)
      • History of Present Illness or Injury (Interactive)
      • Health History (Interactive)
    • Follow Up Forms
  • Dr. Scott Bissell and Taylor Kelley, PA-C

    • New Patient Forms
      • New Patient Packet (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History(Interactive)
      • History of Present Illness or Injury (Interactive)
      • Knee - New Problem or Injury (Interactive)
      • Shoulder - New Injury (Interactive)
    • Follow Up Forms
      • Follow Up Form
      • Follow Up Knee Form
      • Follow Up Shoulder Form
      • Shoulder - Follow Up Appointment
      • Shoulder - Follow Up Appointment (Interactive)
      • Knee - Follow Up Appointment
      • Knee - Follow Up Appointment (Interactive)
  • Dr. Amanda Fantry and Taylor Kelley, PA-C

    • New Patient Forms
      • New Patient Packet (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History (Interactive)
      • History of Present Illness or Injury (Interactive)
    • Follow Up Forms
      • Follow Up Form
  • Dr. Matthew Grosso

    • New Patient Forms
      • New Patient Packet (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History (Interactive)
      • History of Present Illness or Injury (Interactive)
    • Follow Up Forms
  • Dr. Jay Kimmel and Joseph Chappell, PA-C

    • New Patient Forms
      • New Patient Packet (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History (Interactive)
      • History of Present Illness or Injury (Interactive)
      • Knee Questionnaire (Interactive)
      • Shoulder Questionnaire (Interactive)
    • Follow Up Forms
  • Dr. David Kruger and Jessica Temple, PA-C

    • New Patient Forms
      • New Patient Packet (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History (Interactive)
      • History of Present Illness or Injury (Interactive)
      • Dr. Kruger spine questionnaire (Interactive)
    • Follow Up Forms
      • Follow Up Forms
  • Dr. Daryle Ruark and Brian Katz, PA-C

    • New Patient Forms
      • New Patient Forms (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History (Interactive)
      • History of Present Illness or Injury (Interactive)
    • Follow Up Forms
  • Dr. Steven Schutzer

    • New Patient Forms
      • New Patient Forms (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History (Interactive)
      • History of Present Illness or Injury (Interactive)
    • Follow Up Forms
  • Dr. Brett Wasserlauf and Kristin Overton, PA-C

    • New Patient Forms
      • New Patient Packet (Printable Version)
      • New Patient Demographics (Interactive)
      • Health History (Interactive)
      • History of Present Illness or Injury (Interactive)
    • Follow Up Forms
      • Follow Up Forms

For Urgent Care – please download and complete these Patient Forms:

  • Interactive Forms
    •  New Patient Demographics
    •  Health History 
    •  History of Present Illness or Injury

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(860) 728-6740

Advanced Orthopedics New England

  • Bloomfield
  • Enfield
  • Rocky Hill
  • Vernon
  • Springfield, MA
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The orthopedic doctors at Advanced Orthopedics New England offer comprehensive care for orthopedic injuries and diseases affecting the Neck & Back, Shoulder, Hand, Wrist & Elbow, Hip & Knee, and Foot & Ankle.