Registration Forms

In continuing our strive for customer service excellence, Rezin Orthopedics and Sports Medicine has provided the necessary registration forms below. Printing these forms out prior to your visit with us will expedite your waiting process and provide a more efficient visit to Rezin Orthopedics and Sports Medicine. If you choose to use this convenience, be sure to print them out and bring the completed forms with you on your next visit to Rezin Orthopedics and Sports Medicine.

• Patient Information and Registration Form (5 Pages)
• Rezin Privacy Notice (5 Pages)
• Rezin's Financial Policy Form (1 Page)
   (For new patients, or if it has been a year since your last visit)

• Authorization for Medical Record Release Form
   (Complete this form only if you are requesting a copy of your patient records)

• MRI Procedure Screening Form for Patients (2 Pages)
   (For patients who have an MRI scheduled)

• Spine Specialist Forms (3 Pages)
   (For patients who have an appointment with Dr. Ali)