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Patient Forms


 

Patient Forms

Orthopedic Associates PA providers will only refill medications they have originally prescribed. Please double check the name of the ordering provider before contacting our office for a refill. It is best to notify us at the time of your office appointment. If that is not possible, please contact your pharmacy and they will contact us directly. Medications will not be refilled at night and on weekends.


Please print, fill out, and bring forms to your first appointment



If you need a Referral Waiver, please print and fill out this form.


If you require a copy of your medical records, please print and fill out this form.

Location

Orthopedic Associates: Foot & Ankle Specialists
2300 E. 30th Street, Building D, Suite 101
Farmington, NM 87401
Phone: 505-226-7893
Fax: 505-327-7875

Office Hours

Get in touch

505-226-7893