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Download these informational forms for your convenience:

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Patient Information Sheet for Worker's Compensation Claims
Download Adobe PDF File
Download Microsoft Word File

Patient Registration Form
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Patient Interview Form
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Worker's Compensation Form
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HIPPA Forms
Authorization for Use or Disclosure of Personal Health Information PDF File

Release of Medical Information to Relatives PDF File

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All contents of this site Copyright 1999-2002
Interlakes Orthopaedic Surgery, P.C.
293 West North Street • Geneva, New York 14456-1599
430 Clifton Springs Professional Park Clifton Springs. NY 14432

Affiliated with:
Geneva General Hospital,
Clifton Springs Hospital, F.F. Thompson Hospital
Newark Hospital and Rochester General Hospital

Geneva Office - (315) 789-0993
Geneva Fax - (315)789-0281
Clifton Springs Office - (315) 462-3501
Clifton Springs Fax - (315) 462-3503

Office Hours 8:00 - 5:00 p.m. Monday - Thursday
8:00 - 4:30 p.m. Friday

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