Patient Forms

Fondren Orthopedic Group

Below are forms for new patients to Fondren Orthopedic Group. You may download and fill out the forms at home prior to your arrival. There may be additional forms upon arrival depending on which physician you are seeing.

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Patient Access Form

FMLA/Disability Form

Medical Record Requests Form

Referral Form

**New Location NOW OPEN** Walk-ins Welcome at 7718 Garth Road, Baytown, TX 77521

WELCOME

David R. Sollaccio, MD – Hand and Upper Extremity Surgery

COMING SOON

Wame N. Waggenspack, MD – Shoulder and Elbow Surgery – Coming May 5th

Congratulations to Jeffrey A. Kozak, MD who is retiring from active clinical practice on March 31, 2025 after 37 years of exemplary patient care.

Where Does It Hurt?

Patient Forms

Fondren Orthopedic Group

Patient Forms

(Recommended) Get Adobe Reader

Patient Access Form

FMLA/Disability Form

Medical Record Requests Form

Referral Form

Have questions for our staff?

Main Office

Fondren Main

Main Office

Fondren Bracing

Baytown North

Katy

Memorial

Clear Lake

Gulf Freeway, Houston, TX

Baytown

Pearland

Willowbrook

Kingwood

Sugar Land