New Patient Registration Forms
Your first visit to First Choice Medical Group is important and can be most effective if you plan ahead. To assist us in expediting the process when you arrive for your first appointment, please download, print and complete the following forms prior to your visit:
New Patient Registration Forms
- Authorization for Release of Protected Health Information
- Automobile Accident Questionnaire
- Details of Accident or Onset of Symptoms or Illness
- HIPAA Notice of Privacy Practices
- Lower Extremity Symptom and Pain Questionnaire
- Patient Acknowledgement Form- HIPAA Notice of Privacy Practices
- Patient Consent to Treatment Assignment of Benefits and Guarantee of Payment
- Standard Disclosure Acknowledgement
- Upper Extremity Symptom and Pain Questionnaire
To help us in best evaluating your condition, please also download, print and complete the form(s) below that relate to your specific medical concern(s) for which you are seeking treatment.
What Else to Bring
- The designated patient registration forms listed above. You will need to fill them out and bring them with you to your appointment.
- Insurance card(s) and a photo ID. If the appointment is for a minor, you will need to provide the parent’s or legal guardian’s insurance card(s) and photo ID.
- Medical records. Please bring relevant medical records from other physicians, results, and copies of X-rays, and other imaging studies and lab test results.
- Written lists of medications, herbs, vitamin supplements and over-the-counter medications that you are currently taking.
- Your concerns. Be prepared to ask questions or express concerns about your condition when you meet with our care team.
- A family member or friend. Considering asking a friend of family member to accompany you if you require assistance with walking, using the restroom or filling out paperwork.
- Translator. If you need a translator, ask another adult to come with you. Please do not rely on a child to translate for you.
- Comfortable clothing. During your appointment, your care team may require X-rays or an MRI. Wear loose clothing that it is easy to take off and put on.
First Choice Medical Group
Florida Space Coast's Largest Orthopaedic Medical Center of Excellence located in Melbourne, FL.
Arthroscopic knee surgery is a high-tech surgical procedure that is as minimally invasive as possible. It allows the surgeon to see and access the knee joint without having to create a major incision.
Joint injections like Hyalgan are used for pain relief in osteoarthritis patients. This type of treatment can provide effective relief, even if other treatments have failed in the past.
Just as the name implies, joint pain means pain in the body's joints. When the cartilage wears away over time or is displaced for any other reason, the joints can no longer move smoothly because the joint is directly in contact with other bone.
Knee surgery may be needed for many different reasons. Torn ligaments within the knee, tendon injuries, fractures, meniscal tears, and the wearing away of cartilage are all common reasons that people may need knee surgery.
There are a number of different orthopaedic surgeries that are commonly performed. These include rotator cuff repair, joint replacement surgery, arthroscopic knee surgery, shoulder replacements, knee replacements, and much more.
At First Choice Medical Group, our staff aims at providing every patient with the highest quality healthcare. If you have any questions about the insurance policies we accept, please call our office. We are proud to partner with you to help you afford the healthcare that you need.
Patient Success Testimonials