New Patient Forms

During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor.  We accept most insurances.

Patient Forms

Please print and fill out the New Patient forms so we can expedite your first visit.

pdf podiatry patient form downloadNew Patient Form

pdf podiatry patient form downloadNew Patient Form - Minor

pdf podiatry patient form downloadNew Patient Form - Spanish

pdf podiatry patient form downloadNotice Of Privacy Practices

pdf podiatry patient form downloadHIPAA Privacy Practices Consent

Automobile Injury Forms

pdf podiatry patient form downloadPersonal Injury Form

pdf podiatry patient form downloadPersonal Injury Form - Minor

pdf podiatry patient form downloadPersonal Injury Form - Spanish

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

  • Patient's insurance card
  • List of current prescriptions and/or over-the-counter medication, including dose and frequency
  • Information about patient's medical and surgical history
  • Recent test results, x-rays, or relevant records

Insurance and Payment Information

You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please call our office. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

NEW $97 New Patient Special ($650 Value)

Only Available To New Patients! Don't Miss Out, Sign Up Now!

- Private One-on-One Health And Pain Consultation With Dr.
-Specialized Muscle and Nerve Functionality Testing
-Report of Findings and Recommendations
-Two Pain-Relieving Treatments
-No Obligation

*Some Restrictions apply
New Patient Special
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