Patient Forms

Thank you for choosing Barrington Orthopedic Specialists for your orthopedic care. For your convenience, our patient forms may be completed at our kiosk system in our office or are accessible by clicking here to visit our Patient Portal(opens in a new tab).

General Forms

MEDICAL RECORDS REQUEST

NEW PATIENT FORMS(opens in a new tab)

MINOR CONSENT FORM

FINANCIAL POLICY(opens in a new tab)

DENTAL CLEARANCE FORM(opens in a new tab)

NOTICE OF PRIVACY PRACTICES(opens in a new tab)

Provider-Specific Forms

Hasham Alvi, MD

Brooke Belcher, MD

Matthew Bernstein, MD

Rohan Gopinath, MD

Paul Nourbash, MD

Sean Jereb, MD

Thomas Obermeyer, MD

Thomas O'Hara, MD

Narendra Patel, DPM 

Richard Rabinowitz, MD

Jason Rotstein, MD

Brett Schiffman, MD

David Tashima, MD

Mark Yaffe, MD