Patient Forms
Patient Forms
New Patient Forms
Please print PDF and bring these completed forms to your upcoming appointment.
New Patient Forms
Privacy Policy
Financial Policy and Appointment Policy
HIPAA Policy
Please review the HIPPA Policy carefully. It describes how your medical information may be used and disclosed and how you may gain access to that information.
What To Bring
Please bring the following to your upcoming appointment.
Photo ID and insurance card(s).
*New patients are required to provide original cards.List of any medications you're currently taking.
Completed New Patient Forms or Established Patient Forms (if not returned via e-mailed).
Any previous records pertaining to your foot and ankle heath.
* We kindly ask you do not to have large charts faxed to the office.
Podiatrists are considered a Specialty Provider
It is the responsibility of the patient to contact their insurance provider to verify network status of provider and coverage, and obtain a referral from their Primary Dr. if required by their insurance plan.
Referrals must be received 24 hours prior to scheduled appointment.
Please have them faxed to 314-434-8768.