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OAA NEW PATIENT MEDICAL FORMS

All new patients ARE REQUIRED to complete the following medical forms prior to their first visit:

• OAA General Assessment Form (Medical History Form)
• OAA Patient Request for Confidential Information (HIPAA)
• OAA Financial Responsibility Form
• OAA Patient Demographic Letter (learn about the Demographic Information Requirement)

OAA SPINE & RHEUMATOLOGY patients MUST fill out ADDITIONAL FORMS. Please click here for these forms.

OAA PAIN MANAGEMENT patients MUST fill out the appropriate ADDITIONAL FORM.

• For established Pain Management patients please click here
• For new Pain Management patients please click here.

FINANCIAL RESPONSIBILITY POLICY

We ask that all responsible parties read and sign our Financial Policy as well as our Patient Information Forms prior to seeing their Physician.

 

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 appropraite 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 

For OAA Disability Forms and Information please click here