DR. JUREK |
NEW PATIENTS |
Dr. Jurek is a board-certified orthopaedic surgeon specializing in shoulder surgery as well as sports medicine. She has focused fellowship training in both specialities.
More about Dr. Jurek |
NEW PATIENT INSTRUCTIONS AND FORMS I want you to get the most out of your appointment with me. In order to accomplish this, it may be helpful to review your condition or injury on my website and write down any questions you may have. I want to perform a thorough evaluation and ask that you complete all forms in their entirety and review the information below on what to bring to your appointment. For your convenience, the new patient forms are available in PDF format at the bottom of this page for you to complete prior to your appointment. If you complete them online, please print them from your printer and bring them with you for your visit. What to bring to your appointment:
PRINTABLE NEW PATIENT FORMS Patient Medical History Patient Registration Patient Health Information Authorization Financial Policy Notice of Privacy Practices (for review only; does not need to be printed) Acknowledgement of Notice of Privacy Practices ADDITIONAL PRINTABLE FORMS MRI Procedure Screening Form Medical Records Request Form Consent to Treat a Minor Motor Vehicle Accident & Personal Injury Billing Policy Seattle Surgery Center Handbook Swedish Orthopedic Institute Surgery Guide |