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Patient Forms

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Patient Registration – English
Patient Registration – Spanish
Problem Questionnaire – English
Problem Questionnaire – Spanish
Financial Policy
Financial Policy – Spanish
Patient Information
Patient Information – Spanish
Patient Information – Surrogate
Patient Information – Surrogate – Spanish
Patient Information – Workers’ Comp
Patient Information – Workers’ Comp – Spanish
Consent to Use Telemedicine
Medical Records Release

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Santa Barbara Office

The Ryu Hurvitz Orthopedic Clinic
2936 De La Vina Street
Santa Barbara, CA 93105

Tel: (805) 963-2729
Fax: (805) 963-3818
Send us an Email

Santa Maria Office

The Ryu Hurvitz Orthopedic Clinic
2530 Professional Parkway
Santa Maria, CA 93455

Tel: (805) 963-2729
Fax: (805) 963-3818
Send us an Email

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All information contained on the ryuhurvitzorthopedicclinic.com website is intended for informational and educational purposes. The information is not intended nor suited to be a replacement or substitute for professional medical treatment or for professional medical advice relative to a specific medical question or condition.
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NOTICE TO PATIENTS OPEN PAYMENTS DATABASE
For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospital be made available to the public. You may search this federal database for payments made to physicians and teaching hospitals by visiting this website: https://openpaymentsdata.cms.gov

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