NEW PATIENT FORMS

To help make your visit as smooth and efficient as possible, we encourage you to complete your patient forms in advance. Below, you’ll find important documents you can download, print, and fill out before your appointment with our board-certified podiatrist in Canton, MI.

Completing your new patient forms ahead of time helps us better understand your medical history and streamline your check-in process.

Be sure to bring them with you to your appointment

Demographics

Please complete and sign the following demographics form.

Download Form

Health History

Please complete and sign the following health history form.

Download Form

Consent to Treat

Please review and sign the following consent to treat form.

Download Form

Financial Policy

Please review and sign the following financial form.

Download Form

Notice of Privacy Practices

Please review the notice of privacy practices.

Download Form

Privacy Agreement

Please review and sign the following privacy agreement.

Download Form

Canton Foot and Ankle Specialists is proud to provide compassionate and comprehensive foot and ankle care for patients throughout Canton, Garden City, and surrounding Michigan communities.

Have questions? Call us today or contact us online to speak with our team.