Patient Forms
Save time at your first visit: print and complete these forms at home and bring them with you. When you arrive, you will also complete a brief electronic check-in in our patient system.
New Patient Information
One page: your contact details, insurance, the reason for your visit and a brief health snapshot.
Authorization to Release Medical Records
Lets your previous doctor, hospital or imaging center send us your records and MRI or X-ray images before your visit.
What to bring to your first appointment
- Photo ID
- Insurance card(s)
- Completed New Patient Information form
- A list of your current medications and allergies
- X-ray, MRI or CT images (disc) and reports, if done elsewhere
- Referral, if your insurance plan requires one
- Any brace, splint or crutches you are using
- Workers’ comp or auto claim details, if applicable
Questions about forms or your appointment? Call 469-850-0680 or fax 469-850-0681.
Frequently asked questions
Do I have to fill out the forms before my visit?
No, but completing the New Patient Information form ahead of time saves time at check-in. You will also complete a brief electronic check-in when you arrive.
How do I get my outside MRI or records to Dr. Dold?
Bring the images (disc) and reports to your visit, or complete the Authorization to Release Medical Records form so your previous provider can send them to us.
What should I bring to my first orthopedic appointment?
Your photo ID, insurance card, completed new patient form, a list of medications and allergies, and any outside X-ray, MRI or CT images and reports.
Medically reviewed by Andrew P. Dold, MD, FAOA, FAAOS, FACS, FRCSC. This page is general information, not medical advice. Individual results vary.
