New Patient Information

We ask our patients to complete New Patient Forms (available below) before their first appointment. Please download and print the forms, fill them out, and bring completed forms to your first visit to see our podiatrist in Jacksonville, Fl.

New Patient Forms

• Download New Patient Form
• Download New Diabetic Patient Form (choose this form if you are diabetic)

Also, bring the following items to your appointment:

• Insurance card(s).
• Referral forms (if required).
• List of all prescription and over-the-counter medications that you are currently taking.
• Any required co-payment.
• Pertinent medical and surgical history information.
• X-ray films that you may have.
• NOTE: If you are a returning patient and more than a year has passed since you filled out new patient paperwork, you'll be asked to update your information. You can use new patient forms above to update your info.

Insurance and Payment Information

We are a provider for Medicare and most major insurance plans (we do not accept any products of Medicaid, Health Options, or Wellcare). We encourage all patients to confirm their coverage prior to making an appointment. Co-payments are due at the time of the appointment along with supply and service fees not covered by insurance companies. You are responsible for any unpaid balance not covered by insurance.

Please call us with any questions regarding which insurance plans we accept or other billing concerns. Insurance coverage and benefit questions should be directed to your health insurance provider.