We have implemented safery measures to protect the health of our patients and staff, while enabling us to continue to provide high-quality orthopedic care.

To learn more about our response to COVID-19, click here.

Patient Forms

By completing the forms before your next appointment, you can save time on registration.

New Patients

As a new patient to our practice, we appreciate you choosing South Bend Orthopaedics. By filling out these forms ahead of time you will save significant time during your appointment.

Authorization For PHI Use and Disclosure Form

Patient Health History

Acknowledgement Form

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  • University of Notre Dame
  • Saint Joseph Health System
  • Beacon Health System
  •  American Academy of Orthopaedic Surgeons
  • The American Osteopathic Academy of Orthopedics
  • American Association of Hip and Knee Surgeons
  • American Board of Medical Specialties
  • American Board of Medical Specialties
  • American Board of Foot and Ankle Surgery
  • American Orthopaedic Foot & Ankle Society
  • American Orthopaedic Society for Sports Medicine
  • North American Spine Society
  • American Society for Surgery of the Hand
  • American Academy of Physician Assistants
  • Zimmer Biomet
  • Stryker Corporation
  • Arthrex
  • Breg
  • Smith+Nephew
  • DePuy Synthes