Patient Forms

AVORS is pleased to make it easy for patients by providing health-related packets, forms, agreements and notices, on-line. Just click on a link below to download (PDF) the forms. You can then print and fill them out in the privacy of your home at your own pace, and bring them with you completed for your appointment. Please print all forms on "white paper" only.

If you have any questions or need assistance, please call the receptionist at 661-726-5005 ext. 100.

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blue boxOrthopaedic & Podiatric Care

Patient Information, Insurance Information, Assignment & Release, Physician-Patient Arbitration Agreement, Payment Policy, Covered CA and Narrow Network Policy, HIPAA Protected Health Information, Notice of Privacy Practices Acknowledgment, DMEPOS Supplier Standards, and Health History Questionnaire.

"Orthopaedic & Podiatric Care" packetdownload Orthopaedic and Podiatric Care forms packet

blue boxPain Management/Chiropractic Care

Patient Information, Insurance Information, Assignment & Release, Physician-Patient Arbitration Agreement, Payment Policy, Covered CA and Narrow Network Policy, HIPAA Protected Health Information, Notice of Privacy Practices Acknowledgment, DMEPOS Supplier Standards, Pain Management/Chiropractic Care Agreement, and Health History Questionnaire.

"Pain Management/Chiropractic Care" packetdownload Pain Management Care forms packet

blue boxSports Physical

Medical Consent, Patient Information, Pre-Participation Evaluation Medical History, and Sports Physical Evaluation Results.

"Sports Physical" packetdownload Sports Physical forms packet

blue boxWork Physical

Patient Information, Pre-Participation Evaluation Medical History, and Work/DMV Physical Evaluation Results.

"Work Physical" packetdownload Work DMV Physical forms packet

blue boxNotice of Privacy Practices

"Notice of Privacy Practices"download Notice of Privacy Practices

blue boxEDD State of California

For information regarding state disability insurance benefits, go to www.edd.ca.gov

blue boxDMV Disabled Placard or Plates Application

Form Reg195 "Disabled Placard or Plates"download Notice of Privacy Practices

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