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Patients Forms


Big Bend HealthThe Tallahassee Orthopedic Clinic is a proud member of BigBendHealth.com. We would like to encourage all our patients to subscribe to BigBendHealth.com and create your Personal Health Record (PHR). Your PHR will offer you a way to easily organize your basic medical history for easy access by your physician. This will provide quicker service and a faster response to your medical needs as well as safe storage in the event of a natural disaster. BigBendHealth.com is Governed by Health Insurance Portability and Accessibility Act (HIPAA) and Florida Statutes.

To learn what’s in it for you, visit www.BigBendHealth.com.


Below is a list of forms to help you in your visit to Tallahassee Orthopedic Clinic. Please note that every TOC patient must fill out the TOC Patient Information Form.

NOTE: If you are a patient of Dr. Jordan, please complete the Medical History Form for Dr. Jordan in lieu of the Patient Medical History information located in the Patient Information Form packet.

NOTE: If you are a patient of the Spine Clinic, please complete the Spine Clinic Medical History Form in lieu of the Patient Medical History information located in the Patient Information Form packet.

1 Patient Information Forms

TOC Patient Information Forms

TOC Patient Information Form [PDF]

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If you have been scheduled for an MRI, please complete the below MRI Patient Information Forms.

MRI Patient Information Form [PDF] - For MRI Patients Only.

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If you are a patient of Dr. Jordan, please complete the below Patient Medical History Form.

Patient Medical History Form [PDF] - For Dr. Jordan's Patients Only.

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If you are a patient of Dr. Alexander, Dr. Park, Dr. Wingo or Mel Gaston, PA-C, please complete the below Spine Clinic Medical History Forms.

Spine Clinic Medical History Form [PDF] - For Spine Clinic Patients Only.

3 Patient Privacy

Authorization To Release Information Form [PDF]

Our Privacy Policy: Review online

4 Payment Policy

Our Payment Policy: Review online

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