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Download patient forms and other helpful materials for your upcoming hip surgery at The UVM Medical Center.
Request an appointment online with a UVM Medical Group orthopedic specialist.
Returning patient? Log in and schedule your appointment through MyHealth Online.
New patient? Click the button below to request an appointment.
The University of Vermon Medical Center Orthopedics has provided here for your convenience a number of forms related to your upcoming hip surgery, so that you can review and fill these out in the comfort of your home.
If you have any questions about these materials, we would be happy to discuss. Please call us at the UVM Medical Center's Orthopedic and Rehabilitation Specialty Center at 802-847-2663.
NOTE: The following two forms are available in a format that allows you to type in the information on your computer. Click on the links below to open the documents, then click on the form in the area where you need to fill out information and type it in. Once you've filled out the information, save the form to your computer, and print it out to bring to your appointment. You may also print the form out and fill it out by hand if you would prefer.
Please fill out the following two assessments.
NOTE: These pages cannot be saved due to patient data protection, so please print the filled in form before closing the window.
Hip Pain History
New Patient Information Form
Monday 8:00 AM - 5:00 PM
Tuesday 8:00 AM - 5:00 PM
Wednesday 8:00 AM - 5:00 PM
Thursday 8:00 AM - 5:00 PM
Friday 8:00 AM - 5:00 PM
Monday 8:00 AM - 4:30 PM
Tuesday 8:00 AM - 4:30 PM
Wednesday 8:00 AM - 4:30 PM
Thursday 8:00 AM - 4:30 PM
Friday 8:00 AM - 4:30 PM