Patient Forms
Most Common Forms
Click on links for the most commonly used forms. Scroll below for more.
- Orthopaedics: New Patient Form.
- Medicare New Patient Paperwork – All Appointments Effective 1/1/25.
- Therapy Services: New Patient Form and I have a Private Insurance Insurance (e.g., PPO).
Orthopaedic Department
I am a returning OSS patient, but:
- It has been 3 or more years since I was last seen at OSS.
- I need a new orthopaedic provider.
- I have been seen by this doctor before but have a new problem.
- I have changed my health insurance plan or provider.
Pain Management
- NEW PATIENT: I am new to OSS and to Pain Management.
- I am a returning OSS patient, but new to Pain Management.
Imaging (MRI, CT Scan, Bone Density)
- NEW PATIENT: I am new to OSS and to Imaging.
Please complete this form PLUS the relevant form below.
I am a returning OSS patient, but now:
Therapy Department
Includes physical therapy, hand therapy, and chiropractic.
- NEW PATIENT:New to OSS Therapy and have Medicare.
- Medicare New Patient Paperwork – All Appointments Effective 1/1/25.
- NEW PATIENT: New to OSS Therapy and have Private Insurance (e.g., PPO).
- NEW PATIENT: New to OSS Chiropractic.
Additional
Read What Our Patients Say
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“First visit was great! Dr. Korchek was excellent! He is so experienced, and he put me at ease. I received a steroid injection into my shoulder joint and feel better already! ”- Patti
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“They evaluated me carefully, always listen to my feedback, and adjusted workouts to see my progression, and in the end, I was able to be discharged from treatment and return to my normal activities earlier than planned. I definitely built more strength in the program than I had before, and feel confident that I can continue building strength at home with ... ”- Brain M.
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“Got an appointment the very next day after breaking my leg. Thank the doctor at Burbank Urgent Care for calling over the referral. Everyone was very professional and compassionate. The PA and his assistant, Brian, were great at casting my leg with safety and comfort. What a relief! ”- Sai-Ling M.
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“I heartily recommend OSS Elite for anyone with carpal tunnel syndrome or any other hand problem (mine was arthritis in my wrist). The outstanding therapists there are so precise and knowledgeable, fully explain what each exercise does, give excellent training on changes to make in daily life movements, and make sure that each patient knows exactly how to ... ”- Peter L.
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“Everyone at OSS Physical & Hand Therapy (is) kind, professional and courteous. They’ve been such a huge part of my shoulder surgery. Highly Recommend! ”- David B.
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“This is my second time here. First time was for me with Dr Mikael. Second time was for my daughter - she went to see Dr Mikael too. She has a broken Fibula and Tibia. The wait time was spectacular today. Fast! His nurse / RN was on it!. As soon as he came to get us he says oh no! And immediately adjusted her crutches. Took us back and proceeded to take ... ”- Veronica V.