Patient Forms

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

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

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.