Prepare for Your Visit

In order for us to prepare appropriately for your visit, we ask that you take the following steps in preparation for your appointment.

  • Obtain a referral from your primary care physician, if your insurance requires one. Please bring the referral with you or arrange to have your physician's office send or fax it to Concord Orthopaedics.
  • Obtain pertinent medical records, X-rays, MRI, or scans previously completed for this condition and hand carry to your appointment. Please note that any X-rays, MRI or scans performed at Concord Hospital are available to Concord Orthopaedics (including the reports) and it is not necessary for you to contact Concord Hospital. Any and all outside x-rays should be hand carried to your appointment.
  • Complete the Patient History Form and bring it to your appointment (click here to obtain form on-line)
  • Review and sign the Financial Policy and bring it to your appointment (click here to obtain form on-line)
  • Review the Notice of Privacy Practices (click here to review)
  • Review and sign Patient Consent and bring it to your appointment (click here to obtain form on-line)
  • Bring your insurance card(s) to your appointment.
  • Bring your insurance copayment which is due at the time of service. For your convenience we accept MasterCard®, Visa®, Discover®, and American Express®.
  • Please remember that all patients under the age of 18 must be accompanied by a parent or guardian.

Please note that some of our physicians have an additional patient history form related to your specific condition. Should you be seeing one of the providers listed below, review and sign the appropriate form and bring it with you to your appointment.

Dr. Brummett's patient history form - click here
Dr. Nagel's patient history form - click here
Dr. Shirley, Dr. Phillips or Dr. Orzano (Rheumatology) patient history form - click here
Dr. Shirley, Dr. Phillips or Dr. Orzano (Rheumatology) Osteoporosis Questionnaire - click here

Please complete the forms appropriate for the doctor you will be seeing prior to your arrival at our office.

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To our Patients, Families and Communities,

Your health, welfare & safety are paramount when you come for an appointment at any of our facilities. We are closely monitoring the guidance of the World Health Organization and the Centers for Disease Control & Prevention regarding the spread of the virus. Our focus is to ensure we meet our patient’s needs while doing our part to keep you, our associates, and our communities safe. Effective immediately, the Acute Injury Clinic (AIC), will remain open Monday-Friday from 9 a.m. - 4 p.m. The AIC will NOT open on Saturdays.

At this time, the impact to our communities has been minimal and our staff is focused on providing the orthopaedic care our patients expect and deserve. If you have an appointment with us, we respectfully ask that you let us know if you have a fever, cough, and/or shortness of breath in advance of your appointment. Also, if you have recently traveled to or been in close contact with anyone who has traveled outside of New Hampshire, especially to New York State, we ask that you avoid visiting our practice for a period of 14 healthy days.

Thank you for your continued trust in COPA. We appreciate your cooperation as we work to support the health of our patients & employees.

Sincerely,

Ron Chorzewski

CEO