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New Patient Forms

During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor.  We accept most insurances.

Patient Forms
Please print and fill out the New Patient forms so we can expedite your first visit.

pdf podiatry Medicare Patients Only Packet form downloadMedicare Patients Only Packet

pdf podiatry All Other Insurances Packet (Non-Medicare) form downloadAll Other Insurances Packet (Non-Medicare)

pdf podiatry Child Assessment Form downloadChild Assessment Form
(Anyone under 18 MUST complete this form)

pdf podiatry HIPPA Notice Privacy Practices for both Medicare and Non-Medicare Insurances form downloadHIPPA Notice Privacy Practices for both Medicare and Non-Medicare Insurances

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

  • Patient's insurance card
  • List of current prescriptions and/or over-the-counter medication, including dose and frequency
  • Information about patient's medical and surgical history
  • Recent test results, x-rays, or relevant records

Insurance and Payment Information

You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please call our office in Stuart (772) 223-8313 or Jupiter (561) 744-6683. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

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Jupiter & Stuart Podiatry Best Practices and Prevention TipsCertified Podiatry Physicians in Jupiter and Stuart, FL