If you or the person accompanying you to your appointment are experiencing any flu like symptoms, fever, cough, etc. or have recently traveled internationally, we kindly ask you to reschedule your appointment.
We are requesting any person(s) accompanying you to your appointment to wait for you in the car, unless the patient is a minor or requires the assistance of a caregiver.
Welcome to our Practice!
We thank you for giving us the opportunity to participate in your health care. Our mission here at Complete Foot and Ankle Specialists, LLC is to keep you happy, healthy, and active. We do this by learning about your personal situation and providing a comprehensive foot care plan that is tailored to your needs.
To help make your first visit a convenient and a pleasant experience, we ask that you complete the following patient forms prior to your arrival. For your convenience, forms may be completed electronically through our secure website.
- Patient Registration and Insurance Form
- Patient Registration and Insurance Form (Online)
- Financial Agreement Form
- Financial Agreement Form (Online)
- Privacy Notice
- Designation For Release of Medical Information
- Designation For Release of Medical Information (Online)
On the day of your appointment, please bring the following with you:
- Medical Insurance Cards
- If no insurance card is presented at the time of your appointment you may be asked to reschedule your appointment or payment is due in full. We cannot bill your insurance unless we have a copy of the card on file.
- Photo ID
- Your photo ID is required at the time of check-in to protect you from identity theft.
- Referral authorization from your primary care physician, if required by your insurance.
- Please note, you cannot assume your referral was approved unless you have received confirmation from your insurance company. Please call your primary care physician to make sure your referral was completed prior to your appointment. If you have any questions, please feel free to call our billing department prior to your appointment at 937. 404. 2455.
Please be prepared to pay for the following at the time of your visit:
- Co-payment and /or Co-Insurance
- Our office accepts cash, check, Visa, Master Card, Discover and Care Credit
- If you do not have insurance, payment is due in full at the time of service.
We ask that you arrive 15 minutes early to give our staff adequate time to finish your registration. If you are unable to complete your paperwork online prior to your appointment, we ask that you arrive 30 mins prior to your appointment.
If you have any questions prior to your appointment, please let us know. We look forward to meeting you.