Patient Forms


Patient Forms

Please print and bring these forms to your appointment or e-mail it back to the office.

  • Patient Enrollment Packet
  • Privacy Policy
  • Financial Policy
  • Appointment Policy 

Click Here for Patient Forms


E-mail paperwork

  • Save document as PDF
  • Open with Adobe Acrobat Reader
  • Click Tools
  • Click Fill & Sign
  • Complete packet and save
  • Attach document to e-mail
  • Send to


What to bring to your appointment

  • Photo Id and insurance card(s) - New patients are required to provide original cards.
  • List of any medications you're currently taking.
  • Completed paperwork (if not e-mailed)
  • Any previous records pertaining to your foot and ankle heath. (We kindly ask you not to have large charts faxed to the office.)


Please note

  • Podiatrists are considered a Specialty Provider.
  • It is the responsibility of the patient to contact their insurance to verify network status of provider and coverage.
  • It is the responsibility of the patient to obtain a referral from their Primary Dr. if required by their insurance plan. 
  • Referrals must be received 24 hours prior to scheduled appointment. Please have them faxed to 314-434-8768.
  • Our office does accept patients who do not have insurance as a Self Pay. Charges are due at time of service.