Patient Information and Forms

Welcome New Patients. Our Dyker Park Footcare Podiatry Team In Brooklyn Is Ready To Help You!

What to Bring to Your Appointment

Please contact our office to schedule an appointment. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know our Podiatrists. We accept most insurances.

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 

Forms for Your Appointment

To save time, you can fill out your form before your scheduled visit.

Click on the button below to download the convenient PDF fillable form to be completed for your visit. Fill out the form in its entirety. Please note: you will need Free Adobe Acrobat Reader or Preview on a Mac to view and type into this form

Accepted Insurance & Payment Information

We accept most of the major medical plans in our community, please see list below.

Please bring your insurance card. We will need a copy of it for our records. If your insurance plan requires that you have a referral from your primary care doctor, please make sure you obtain one before your appointment. Please feel free to call (718) 745-6220 our office to verify your insurance plan.

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 (718) 745-6220 . Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

ACCEPTED INSURANCES

  • AARP

  • Aetna

  • Americhoice

  • Cigna,

  • Elderplan

  • Empire BC/BS

  • Empire Plan

  • GHI

  • Healthfirst

  • HealthPlus

  • Magnacare

  • Medicare

  • Medicare Advantage Plans

  • Oxford

  • United Healthcare

  • Union Plans

  • 1199