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Central Montgomery Orthopedics
Forms for
Workman's Compensation or 
Motor Vehicle Accident Claims

A. Patient History Form

Microsoft Word version

Adobe Acrobat PDF version

B. Patient Demographics Form

Microsoft Word version

Adobe Acrobat PDF version

C. Consent to Use and Disclose
     Protected Health Information

Microsoft Word version

Adobe Acrobat PDF version

D. Notice of Privacy Practices

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