New patients must complete the New Patient Registration Packet 

Please also visit " Your First Visit Instructions" page

Established patients 

also complete all forms if it has been more than one year since you have been to the office. 

Everyone : 

note the optional Sports Medicine Form.

Click light blue highlight  to print entire New Patient Initial Registration

YOU ARE WELCOME TO DO TWO SIDED PRINTING TO SAVE PAPER.

 or, click on each individual form listed below or from document download list

  when updating records, or if you only need one page to reprint .  

New patient registration packet

which contains  all five of the following brief simple  individual forms to complete.

#1 Patient Contact & Insurance Information Also use this separately if at any time your insurance changes, or you move or make other changes .   

#2 Consents and Policy Agreements

#3 Podiatric History Information   Use this separately if coming to the office as a return patient months or years later.  For example, you first are seen for an infected ingrown toenail.  Months, or ayear later, you develop heel pain,  or hurt yourself.  If your insurance has not changed, and no medication changes, then this is all you need to fill out. 

#4 Medical History Information  

#5 Privacy Statement Signature Sheet  Note, you only need to bring to summary sheet is for your own use / file; and the complete form is available  under the optional file documents listed below.

 #6 Optional Sports Medicine History Form 

Anyone can complete this form who walks, runs or otherwise exercises on their feet regularly.   It is not required if you are, for example, coming in to have an ingrown nail or wart taken care of for your first visit.   However, if you have the time, still do it.  

Definitely complete this if you are coming in to have a pain or condition evaluated that is not  visible externally , even if your pain is not , for example, associated with running, but is noted at another time of the day.   

With each new injury over the years, completing this form with new information will be beneficial

File attachments  downloads listed that we also include for your optional review, but are not needed to print for any  appointment  include

notice of nondiscrimination in delivery of health care

entire privacy statement literature

product standards

You will need adobe Acrobat Reader to view forms. This is a free download. Click the Acrobat Icon to go to a page to download Reader.