Below you will find links to our new patient intake forms. Clicking on the links will open a printable file. Please fill out these forms and bring them with you to your first appointment.

Be sure to read our Summary Notice of Privacy Practices


For new patients visiting our practice, we have provided a few reminders to prepare for your first visit.
  • Please bring:
    • Your insurance cards with you
    • A copy of your medication list
    • Completed new patient check in forms which are available on this site

  • Wheelchairs are available for use at our Jacksonville and Springfield facilities.

  • While we accept most major medical plans, it is beneficial for you to check with your insurance carrier to make sure we are in network for your plan.

  • If you are on medicare and your visit will entail routine foot care, we will ask you when the last date of visit to your primary care physician was. This is information that is requested by medicare for billing purposes.

  • Insurance office visit co-pays are collected at the time of visit.

  • Most HMO (Health Maintenance Organization) Plans require that you obtain a referral form from your primary care doctor in order to see a specialist. Please make sure this is secured from your doctor ahead of time and brought with you for your visit. If a referral is not obtained prior to your visit your insurance may deny your claim and result in the visit’s balance being your responsibility.
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    New Patient Information Form


    Notice of Privacy Practices
    Acknowledgement Form



    Information for existing patients of Foot & Ankle Associates who are presently recieving treatments or have undergone procedures can find important information below.
    Pre-Operative Instructions
    Post-Operative Instructions
    Running Shoe Guide
    		 Post-Operative Nail Instructions
           
    		 
    Cast Care
    Stretching Exercises
    Choosing Correct Shoes
    		 


    © 2011 Foot & Ankle Associates.
    All Rights Reserved.