To help make your visit to The Stone Clinic easy and efficient, please print out and complete these forms prior to your arrival. 
     •  PDFs: download, print and fill out by hand. 
     •  WORD files: download and fill out right on your computer, then print.  Please note: 
        use the TAB button to move between fields in the WORD form.

All patients should fill out the:
Patient Sign In Form (PDF).
Patient Sign In Form (WORD)

If you have a neck, shoulder, elbow, wrist, or hand problem, please print out and complete  the:
Upper Extremity History of Injury form (PDF).
Upper Extremity History of Injury form (WORD).

If you have a lower back, hip, knee, ankle, or foot problem, please print out and complete the:
Lower Extremity History of Injury form (PDF).
Lower Extremity History of Injury form (WORD).

If you are visiting from out of town or interested in an Outside Consultation, and have a knee problem, you may have your MRI and Xray imaging done at home and transmit the images to us.  Please refer to the Knee Imaging Views form (PDF).  We will need these images in order render an accurate diagnosis.  


Please Note:

If you are a patient with a knee problem, we ask you to take a few extra minutes and complete the following three forms.  The Stone Research Foundation uses these forms to improve existing treatments and create new ones.  Many thanks.

IKDC Subjective Knee Evaluation Form (PDF)
IKDC Subjective Knee Evaluation Form (WORD)

WOMAC Form (PDF)
WOMAC Form (WORD)

Tegner Activity Level Scale (PDF)
Tegner Activity Level Scale (WORD)