Patient Forms

New Patient Form

Dr. Young’s New Patient Questionnaire (If you are scheduled to see Dr. Steven Young, please print, fill out and bring to your first appointment.)

MRI questionnaire (For patients scheduled for an MRI at OISI. Please print, fill out and bring to your appointment.)

Billing Information (Explanation of billing for fracture care and casting.)

Financial Policy (This printable form describes our financial policies in detail. Please print, sign and bring to your first appointment.)

Notice of Privacy Practices

Medical Records Release to OISI (Please print and fill out this form if you are requesting records be sent to OISI.)

Healthy Bone Clinic Registration Form

Healthy Bone Clinic Registration Checklist

Medical Records Release From OISI

COVID-19 Precautions

We at Orthopaedic Institute of Southern Illinois are committed to continuing to provide the highest quality and safest orthopaedic care to the people of Southern Illinois.

In the interest of protecting our patients and employees, we have instituted the following procedures:

All patients will be screened according to CDC recommendations via telephone prior to their scheduled appointment date. These recommendations include screening for a fever, cough, shortness of breath. Upon arriving at any of our facilities, all people will be screen upon arrival.

We will not be allowing any visitors to accompany patients with the exception of a single parent accompanying a minor or a designated caregiver accompanying an impaired adult.

At this time, we will continue to provide full physician services in the office as well as physical and occupational therapy, imaging, pain management, and Urgent Care services for your urgent orthopaedic needs.

We are working closely with our hospital partners for the continued provision of urgent and emergent orthopaedic care.

Please remember to stay calm, stay smart, and if you are feeling ill, stay home.

Thank you,
The Physicians and Staff of Orthopaedic Institute of Southern Illinois.

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