Patient Services at Jewett Orthopaedic Clinic
We want to make your experience with us as simple and efficient as possible. By downloading patient forms located in the gold box below, our office will have the opportunity to properly prepare for your arrival. Please complete and fax everything within this box that applies to you, our patient. Our fax number is (407) 643-2801
Welcome to Jewett Orthopaedic Clinic!
If you are a new patient to Jewett, (age 18+), please complete the following information.
Patient Registration Information (all new patients)
Consent to Use or Disclose Protected Health Information (all new patients)
Consent for Electronic Prescribing (all new patients)
Assignment of Benefits and Direction for Payment
and Assignment and Lein for Medical Services Rendered (all new patients)
Medical History Forms
Adult Medical Registration and Medical History Forms (ages 18+)
Child Medical Registration and Medical History Forms (ages 0 -18)
Request for Medical Records
Please select the desired location and download and fill out the form provided.
Request for Copies of Radiology (X-ray films/CD's)
Please download and fill out the form provided.
PT, EMG Services
- Electrodiagnostic Studies (EMGs/NCVs)
- Orthotic Devices (braces, splints, etc.)
- Occupational Therapy
- Physical Therapy
Jewett History
Jewett has been providing innovative care for over 75 years. See our timeline of progressive leadership. View Timeline »