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Thank you for your consideration, as we are all doing our part to avoid the spread of the Coronavirus.

New Patient Forms

Information for New Podiatry Patients

Chicago Heights, Olympia Fields, IL 60461 new patients informationDuring 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 patient form downloadNew Patients

Before Going to Foot Doctor:

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

Podiatry 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 (708) 748-7653 in Chicago Heights, Olympia Fields, Illinois. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

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