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State College Podiatrist | State College Overview | PA | Company Name |

Larry J. Assalita, DPM

Fellow : American Academy of Podiatric Sports Medicine
Board Certified
: American Board of Podiatric Medicine
Board Certified in Foot Surgery
: American Board of Foot and Ankle Surgery

Total Family Foot Care Emphasizing Patient Education

110 Regent Court, Suite 200
State College, PA 16801
 814-238-0675
Overview

Updated Office Schedule!

 

New patients must complete the New Patient Registration Packet

Also, take a look at the “Your First Visit" page


 

Established patients:

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.


 

Description of Patient Forms

New Patient Registration

#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

#7 Records Release Forms

#8 Optional Forms For Reviews

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


The documents listed below are for your review, but are not needed for any appointment:

Notice of nondiscrimination in delivery of health care

Entire privacy statement literature

Product standards

 
 
State College Podiatrist Company Name is a poidiatry office providing Overview, orthopedic, pain, diabetes, bunions and much more in State College, PA. We also do Achilles Tendonitis, Athlete's Foot, Calluses, Diabetic Foot Care, Flatfoot (Fallen Arches), Ganglions, Haglund's Deformity, Hallux Rigidus, Hammertoes, Heel Pain/Fasciitis, Infections, Injuries, Metatarsalgia, Morton's Neuroma, Osteoarthritis, Plantar Fasciitis, Posterior Tibial Dysfunction, Rheumatoid Arthritis, Running Injuries, Sesamoiditis, Sprains/Strains, Tarsal Tunnel Syndrome, Bunionette/Tailor's Bunion, Tendonitis, Toe Deformities and all work related in the 16801-7966 area and surrounding areas in State College