On-line New Patient Forms

To expedite your appointment we recommend all new patients to complete our on-line patient forms. This will help our staff and doctor review your medical history before your appointment and in-put all necessary information into our electronic health records. Make sure that you list all medications with correct spellings and dosages. Previous surgeries should have at least a year when performed.

Completing these forms on-line will require you to arrive ½ hour prior to your appointment time as opposed to 1 hour.

Please be aware that this can take between 15 to 45 minutes to complete based on the complexity of your medical history. We encourage you to leave enough time to complete this process in it's entirety.

1. New Patient Forms Please remember to click the ‘Submit’ button at the end of the form for it to come back to us encrypted. Once submitted please complete PAD Questionnaire below if applicable.
2. PAD Questionnaire (only necessary for patients 50 years old and over). Once completed click the ‘Submit’ button at the end.
3. Notice of Privacy Practices

On-Line Existing Patient Update Questionnaire

Please take the time to complete our on-line update questionnaire if you are a returning patient that has not been seen in the past 6 months or more.This will help our staff and doctor review your medical history before your appointment and in-put all necessary information into our electronic health records. This will also assure that your appointment stays on-time to afford you the most time with your doctor.

As always please arrive 15 minutes prior to your appointment time.

• Click Here for our on-line Update Questionnaire

Referrals

Patient Referral Bonus Rewards
Here at the Advanced Footcare Clinic new patients are always welcome! In recognition of your continued support and loyalty to our clinic we would like to extend our gift to you for recommending our practice to your family and friends.

With every successive referral the reward grows! Just a token of our appreciation that you have put your trust in us for providing all your foot care needs.