New Patient Forms

New Patient Forms

Thank you for scheduling an appointment with The Foot and Ankle Treatment Center.

FATC-father-daughter-walkTo serve you better, we are now offering you the opportunity to download and complete your new patient registration forms before your visit. This will help you avoid feeling rushed when you come to our office for your first appointment. Please complete your medical forms at your convenience, in a comfortable and secure environment. For more information on how your personal information is kept secure, click here.

Please complete this form in its entirety. Accurate information about your medical history and symptoms permits your Foot & Ankle Treatment Center team to make the best possible treatment decisions.
Please bring your completed form, a copy of your insurance card and photo identification to your appointment to ensure quick and accurate service.

You will be responsible for any out-of-pocket expenses (co-pay, co-insurance, deductibles, and durable medical equipment, etc.) at the time of your visit. We accept checks, cash, Visa, MasterCard, and Discover.

Thank you!patient forms icon