Patient Forms & Policies

Thank you for choosing Dr. Jason Lowenstein!

In preparation for your first appointment, please print out and review the following documents. Please note that all patients should fill out the registration form, which includes basic contact and insurance information. In addition, adult patients should complete the adult version of the Spine History form. This 5-page document provides a detailed review of your past medical history, as well as your current symptoms. Workman’s compensation patients should be sure to fill out the appropriate section on work-related injuries.

For pediatric patients, please complete the pediatric version of the Spine History form. This form contains questions that are specifically tailored to children with spinal deformities, such as scoliosis or kyphosis.

In addition, both adult and pediatric patients can use the “Your Providers” form to disclose contact information for a variety of professionals that make up your care team from primary care physicians to cardiologists and pulmonologists. Disclosing this information will enable Dr. Lowenstein to deliver an integrated and holistic approach to designing your care plan.

If you would like for our team to send your medical records to another provider, you may request copies using the “Medical Records Request & Release” form. In addition, please review our prescription and financial responsibility policies to learn more about how to process refill requests, billing matters, and more. We look forward to meeting you soon!

More About Dr. Lowenstein

Dr. Jason Lowenstein is a board-certified, fellowship-trained scoliosis and spinal deformity surgeon with over a decade of surgical experience. Our spinal deformity team recruits the latest advancements in conservative treatments and minimally invasive procedures to ensure that your loved one recovers with minimal pain and maximum results. Whether your require conservative techniques, like scoliosis bracing, or surgical interventions, like spinal fusion, our team will create a treatment plan that is tailored to your specific needs. Thank you for choosing Dr. Lowenstein for all your spine care needs!

Patient Forms

Registration Form

Spine History (Adult)

Spine History (Pediatric)

Your Providers

Medical Records Request

Prescription Policy

Financial Responsibility