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  • Phone: (201) 445-2830
  • Fax: (201) 445-7471

Ridgewood Orthopedic Group

A division of OrthoNJ

  • Our Team
    • Louis F. Amorosa, MD
    • Andrew A. Brief, MD, FAAOS
    • Umer R. Dasti, MD
    • Anthony J. Delfico, MD
    • Brian J. DePalma, MD
    • Ismar Dizdarevic, MD
    • James F. Giordano, MD
    • Mark M. Pizzurro, MD
    • Kevin Roenbeck, MD
  • Locations & Hours
    • Ridgewood Orthopedic Group
    • Mahwah Location
  • Patient Resources
    • HIPAA Notice of Privacy Practices
    • Our Policies
    • Accepted Insurances
    • Medical Forms
    • Testimonials
    • Accessibility Statement
    • Notice of Nondiscrimination
    • SMS Policy
    • Your Rights & Protections Against Surprise Medical Bills
    • Your Rights to a Good Faith Estimate
    • Disability Forms and Information
  • News
  • Patient Education
    • Foot, Ankle and Lower Leg
    • General Body
    • Hand
    • Head, Neck and Spine
    • Hip
    • Knee
    • Mako Joint Replacement
    • Shoulder
    • Spine
    • Sports Medicine
  • Physical Therapy

Medical Forms

Download Forms

  • Privacy Notice (HIPAA)
  • Medical Records Request – Requests will only be completed if all sections of the request form are filled out.

If you cannot access the forms you can click on the icon below to download the software.

Please sign in to our patient portal to complete medical forms at least 24 hours prior to your visit with us. This will help to expedite the registration process. Please be sure to document your complete medical history when you fill out our forms. It is very important that you tell us about all medications and vitamins that you are taking with the doses and frequency that you take them, all of the doctors/medical specialists that you see regularly, and all past surgeries that you have had. You will also receive a phone call from our nurse to review your medical history.

A pdf version of our Patient Privacy Notice (HIPAA) is available for download on this page for your records. You will need to download a pdf viewer in order to view the form; if needed, please download Adobe reader.

Medical records are available upon request. Patients, please download and fill out the Record Request form and fax to 201-445-7471 or email to records@ridgewoodortho.com. For inquiries regarding previously submitted requests from a patient, legal or a doctor, please call extension 190.

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Contact Us

Ridgewood Orthopedic Group
A division of OrthoNJ
85 South Maple Avenue, 2nd Floor, Ridgewood, NJ 07450

Mahwah Location
A division of Ortho NJ
1400 MacArthur Blvd., Clinical Suite A, Mahwah, NJ 07430
Located within The Valley Center for Health and Wellness

Phone 201-445-2830 
Fax 201-445-7471

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Ridgewood Orthopedic Group
Physical Therapy

A division of OrthoNJ
85 South Maple Avenue, 1st Floor, Ridgewood, NJ 07450

Phone 201-445-2831 
Fax 201-445-0246

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