New Patient Form

HIPPA Privacy & Authorization Form

To prepare for your first appointment you may download, complete, and bring these forms with you to your appointment. The downloadable PDF forms below require Adobe Reader for viewing. You have the option to print and fill out or to type in the information directly from your browser and print when completed.

If you don't have Adobe Reader, click the icon above to download and install the free version of their software.

Your rights as a patient and our obligations as your health care provider…

Flagstaff Foot & Ankle Specialists accepts…

and most other major insurance carriers.

8 West Columbus Ave  *  Flagstaff, AZ 86001  •  (928) 226-7555