Patient Forms
Most Common Forms
Click on links for the most commonly used forms. Scroll below for more.
- Orthopaedics: New Patient Form.
- Medicare New Patient Paperwork – All Appointments Effective 1/1/25.
- Therapy Services: New Patient Form and I have a Private Insurance Insurance (e.g., PPO).
Orthopaedic Department
I am a returning OSS patient, but:
- It has been 3 or more years since I was last seen at OSS.
- I need a new orthopaedic provider.
- I have been seen by this doctor before but have a new problem.
- I have changed my health insurance plan or provider.
Pain Management
- NEW PATIENT: I am new to OSS and to Pain Management.
- I am a returning OSS patient, but new to Pain Management.
Imaging (MRI, CT Scan, Bone Density)
- NEW PATIENT: I am new to OSS and to Imaging.
- All MRI and CT Scan forms can be found on this link from Imaging Specialists of Burbank - Pacific Ave.
Please complete this form PLUS the relevant form below.
I am a returning OSS patient, but now:
Therapy Department
Includes physical therapy, hand therapy, and chiropractic.
- NEW PATIENT:New to OSS Therapy and have Medicare.
- Medicare New Patient Paperwork – All Appointments Effective 1/1/25.
- NEW PATIENT: New to OSS Therapy and have Private Insurance (e.g., PPO).
- NEW PATIENT: New to OSS Chiropractic.
Additional
Read What Our Patients Say
-
“Got an appointment the very next day after breaking my leg. Thank the doctor at Burbank Urgent Care for calling over the referral. Everyone was very professional and compassionate. The PA and his assistant, Brian, were great at casting my leg with safety and comfort. What a relief! ”- Sai-Ling M.
-
“Dr. Korchek is amazing. I can’t say enough about him. He was informative and honest and put me at ease explaining everything, ”- M.C
-
“I heartily recommend OSS Elite for anyone with carpal tunnel syndrome or any other hand problem (mine was arthritis in my wrist). The outstanding therapists there are so precise and knowledgeable, fully explain what each exercise does, give excellent training on changes to make in daily life movements, and make sure that each patient knows exactly how to ... ”- Peter L.
-
“Dr. Shahan Yacoubian replaced my left hip in October. I went in with full confidence because not only was I referred by my trusted physician, but leading up to the surgery I met so many others who had recently had hip or knee surgery and highly recommended him. Since my VERY SUCCESSFUL hip replacement, I've met even more of his happy patients. It just ... ”- Tina P.
-
“I could not walk I had to hop, my hip was really bad and was in need of total hip replacement. I was sent to Shahan Yacoubian I have not felt so good in the last 5 years, Dr Yacoubian reassured me that / will be better, I have not be so happy in years, I personally recommend him with being a top Dr that I have ever had and I would go back to him in a ... ”- Sheila C.
-
“Dr. Moses was Fantastic He diagnosed my hand problem and gave me all the information I needed to know about having a Trigger Finger. I've never had an appointment go so well. Kudos to the entire staff. ”- P.C.