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C H Martin Company
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Patient Forms

Patient Forms

Patient forms available for download and printing:

Patient-Information-Form
Patient-Questionnaire-Form
Patient-Consent-Form
Work-Comp-Patient-Form

New-HIPAA-Form
Patient-Consent-(Spanish)
Patient-Information-(Spanish)
Pediatric-Questionnaire-Form-(Spanish)

About

C. H. Martin Company provides custom fabricated orthotic and prosthetic devices using componentry from different technologies for the pediatric and adult population. Other Services include: compression garments, fracture orthoses, hand splints, scoliosis orthoses, Taos Walker, and theratogs. We provide other off the shelf items such as wrist braces, knee braces and back braces.

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Contact us
  • Atlanta office : 329 Marietta St. NW Atlanta, GA 30313
    office: 404-525-1533  fax: 404-525-9819
  • Augusta, GA office : 1456 Walton Way Suite B Augusta, GA 3090
    office: 706-849-9998  fax: 706-849-2272
  • Conyers, GA office : 2395 Wall Street Suite 180 Conyers, GA 30013
    office: 770-761-7668  fax: 770-602-4316
  • Dublin office : 220 Industrial Blvd Suite D Dublin, GA 31021
    office: 478-275-9444  fax: 478-275-1089
  • Fayetteville office : 101 Devant St., Suite 402 Fayetteville, GA 30214
    office: 770-719-3110  fax: 770-719-3109
  • Marietta office : 472 North Sessions Street, NW Suite 21 Marietta, GA 30060
    office: 770-499-1940  fax: 770-499-7930
  • Rome office : 170 Shorter Ave, NW Rome, GA 30165
    office: 706-236-9911  fax: 706-236-1937
  • Stockbridge office : 135 Medical Blvd Stockbridge, GA 30281
    office: 678-289-2211  fax: 678-289-2233
  • Suwanee office : 345 Peachtree Industrial Blvd Suite 1202 Suwanee, GA 30024
    office: 770-271-7540  fax: 770-271-5553
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