Patient Forms

Patient Forms

 

New Patient Forms

Please print and bring these completed forms to your upcoming appointment or e-mail them back to the office at podiatry@woodlakepodiatry.com.

  • New Patient Forms

  • Privacy Policy

  • Financial Policy and Appointment Policy 


Established Patient Forms

If you are currently a patient with Woodlake Podiatry, please fill out the 2022 returning patient paperwork to ensure your information is up-to-date.


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.

e-Mail Completed Form

 

Please note: If you are unable to e-Mail the completed Patient Forms;
please print, fill out, and bring the completed forms to your upcoming appointment.

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Download

After clicking on the New Woodlake Patient Form PDF or Established Patient PDF link, save the document as a PDF.

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Adobe Acrobat Reader

Open the blank PDF in Adobe Acrobat Reader. Once open click “Tools”, then the “Fill & Save” option.

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Complete

Using the “Fill & Save” feature, complete all items in lines and save the finished PDF.

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Send

Open your e-mail, attach the completed PDF to a new email addressed to our office email address.

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.