Patient Forms

New Patients

Once you have made your initial appointment, you may pre-register by downloading, printing, and completing the patient forms below. Please be sure to bring them with you to your first visit. Completing the forms prior to your visit will help speed up the new patient registration process.

Alternatively, you can fax us your forms. Our fax number is (315) 785-6874, attention Medical Records.

Downloadable Forms:

• Notice of Privacy Practices
• Surprise Billing Notification
• Health History
• Disclosure of Protected Health Information
• North Country Orthopaedic Group Authorization to Release Protected Health Information
• North Country Surgical Specialist Authorization to Release Protected Health Information
• Diabetes, Osteoporosis, & Endocrine Center Authorization to Release Protected Health Information

Established Patients:

Please sign in to our patient portal to request an appointment and update forms. If you have not registered for our secure portal or have not received authorization to begin using the portal, call our office to obtain a registration PIN. For more information on the patient portal, click here.

Should you need anything else or have questions, feel free to contact us.

Medical Records Requests:

Please download and complete the "Authorization to Release Protected Health Information" above. Completed forms should be:

• faxed to (315) 785-6874, attention Medical Records; or
• mailed to North Country Orthopaedic Group;   ATTN: Medical Records;   1571 Washington Street, Suite 201;   Watertown, NY 13601