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Medical Forms for Patients

Provided below are various forms that require completion prior to your visit and/or surgery.

Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. This will allow you to download the software, providing access to the forms.

Please bring the completed form(s) with you to your scheduled visit. This will help expedite the registration process.

Click the links below to download the PDF Form

Patient Intake Form

Privacy Notice (HIPPA)

Prescription Agreement Form


Patient Portal Link

Patient Portal Link


Patient FAQs

Brooklyn Premier Orthopedics is a leading care center in orthopedics. Our mission is to provide quality care to patients who suffer with conditions, ailments, and pain in musculoskeletal areas of the body which include: the neck, spine, shoulder, hip and extremities. Selecting Brooklyn Premier Orthopedics for your orthopedic needs will ensure you see brilliant experienced specialists in orthopedic care in the New York Area.

How do I make an appointment?

You can call use at 718-576-6822

or

Use click the following link: Contact Us and fill out the contact form.

What do I bring to the office with me for my visit?

You should bring your driver’s license, valid ID, insurance card, as well as a referral and pre-certification information, if applicable. If you have chosen to complete the patient forms in advance, please remember to bring them to your appointment.

You should bring copies of all pertinent medical records such as doctors’ notes and laboratory and imaging results, including actual films. This information helps your doctor to understand your medical history, make a diagnosis, and suggest treatment options.

What is the office like?

Brooklyn Premier Orthopedics serves a diverse group of patients in a spacious facility located on Newkirk Avenue in the Ditmas Park neighborhood of Brooklyn, New York. The Newkirk location conveniently shares a lobby with Back to Health Physical Therapy group. Brooklyn Premier Orthopedics maintains a steady flow of patients receiving expert care from orthopedic and pain management specialists. Wait time varies depending on day and the condition.

How early should I arrive to my appointment?

Please plan on arriving 15 minutes prior to your scheduled appointment time.

What insurance plans do you accept?

Providers at our practice participate in most major insurance plans. Our call center will review your insurance information and schedule you with the appropriate provider.

What is a PA?

Physician Assistants are extensively trained in the practical knowledge and skills required for effective clinical care. At Brooklyn Premier Orthopedics, and in many other settings, PAs practice similarly to physicians, often acting as primary providers for their patients. They make diagnoses, prescribe treatments, and can handle all orthopedic issues and procedures, consulting their MD colleagues as needed.

What is the “no-show” policy?

If you are unable to keep your appointment, please call the office as soon as possible. If you miss your appointment and do not call to cancel, additional fees may apply.

How do I retrieve medical records?

To request medical records, please call the office 718-759-6100 ext. 3007 or e-mail mr@bportho.com Attorneys please contact medical records for account log-in and password for access to Citrix.

Who can I call if I have a billing question?

For billing-related questions, please call 718-650-6018.