Tri-State Orthopaedics & Physical Therapy
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Patient Forms

Provided below are various forms that require completion prior to your visit and/or surgery. Please download the appropriate form as directed by your physician and/or staff by clicking on the name of the form. If you cannot access the form, please click on the Adobe icon. This will allow you to download this software, providing access to the forms. Please bring the completed form(s) with you to your scheduled visit. This will help expedite the registration process. Thank you.

Privacy Notice (HIPAA)HIPAA and Patient Packet form

Patient RegistrationPatient Registration

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Dr. Apurva R. Dalal, MD, Board-Certified Orthopaedic Surgeon
For appointment call Tri-State Orthopaedics, LLC. Apurva R. Dalal, MD Germantown Office: 901 .333. 2525, Memphis Office: 901 .346 .5488
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