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Patient Forms
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Welcome to Buffalo Spine and Sports Medicine!  We welcome you and are happy to have you as a patient of the practice.

 If you are a NEW patient, you will need to prepare for your first visit.  

  1. Read and become familiar with the Office Policies of Buffalo Spine and Sports Medicine.  
  2. Complete the Online Patient Forms and the  Medical History form.   
  3. When you arrive to your first visit, you will be asked to complete the Authorization for Release of Health Information Pursuant to HIPPA form.   

The Online Patient Forms provides the practice with basic information about yourself, your insurance information, your medical history, a release form and explains the policies of the practice.   Upon completion of each page,  please be sure to click on the blue submit button located at the bottom of the screen.  

If you cannot complete the Online Patient Forms, please call Buffalo Spine and Sports Medicine at 716-626-0093 and request a paper copy to be mailed to your home.  

 For returning patients:

We encourage you to browse thru our website and use the patient portal.  

 What to bring to your first appointment:

  • All completed registration forms (Online Patient Forms and Medical Form from above)
  • Drivers License
  • Insurance Card and Insurance referral (if required)
  • CT, MRI, XRays and any related written medical reports
  • List of Medications and Supplements you are currently taking, along with the dosage
  • Any Physical therapy or chiropractic appointment dates related to your condition
  • Comfortable clothing

 Auto Injuries:

  • Insurance company claim number
  • Policy number
  • Adjuster name and phone number 

Workers Compensation:

  • Insurance company claim number
  • Policy Number
  • Adjuster name and phone number
  • Name and address of Worker's Compensation carrier
  • Name, address and pone number of your employer at time of accident

Physical Therapy:

  • Gym shorts or loose fitting, comfortable exercise apparel
  • Please wear or bring sneakers or athletic shoes
  • Patients under the age of 18 must be accompanied by a parent or have written consent of parent or guardian. 

Appointments:

Please arrive promplty for your appointment.  Your appointment time has been reserved specifically for you.  Failure to arrive on time or bring all pertinent information, may result in a delay or possible appointment rescheduling. 

Cancellation of appointments requires a 24 hour notice.  Failure to comply to this cancellation policy may require up to a $50 payment prior to rescheduling your appointment.  

 





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