pic

New Patient Form

New Patient Form

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 Form

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

DOWNLOAD NEW PATIENT FORM

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
(212) 486-7333. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

NYC Foot Care, PC
✆ Phone: 212-486-7333
Address: 184 East 70th Street, New York City, NY 10021

✆ Phone: 212-486-7333
Address: 121 East 60th St, Suite 3D, New York City, NY 10022

✆ Phone: 212-486-7333
Address: 162-15 Highland Avenue, Suite 1D, Jamaica, NY 11432

✆ Phone: 212-486-7333
Address: 459 South Oyster Bay Road, , Plainview, NY 11803

✆ Phone: 212-486-7333
Address: 15-01 Pollitt Drive, Suite 8B, Fair Lawn, NJ 07410

5