New Patient Paperwork

Thank you for choosing Shoal Creek Foot & Ankle Center! To help get you the best care in the fastest time, download and print the New Patient Registration Packet below. Go ahead and fill it out now and bring it with you to your first appointment. This will help us process your information and get you seen as quickly as possible.

Your First Appointment

Please arrive early so we can finalize any paperwork and remember to bring:

• Your insurance card(s) and photo ID
• Your medical and surgical history
• A list of current medications (over-the-counter, too) including dose and frequency
• Any recent test results, MRI/CT images on a disc, or relevant medical records

It’s your first appointment. Are you wondering what to expect? Here’s what will happen:

• Check in at the front window. The ladies will have a New Patient Registration Packet for you to fill out (Or why not do it now? Just click the download button above.). While you do that, they’ll verify your insurance.
• When your paperwork is done and insurance is confirmed, we’ll collect your payment according to your insurance benefit coverage details. For most people, it’s a specialist copay.
• Next, you’ll be taken to an exam room. You get to relax in the big blue exam chair.
• Soon, a Medical Assistant will be in. She’ll have you take off your shoes and socks. She’s also going to ask a lot of questions about your condition. Depending on your answers, she might get x-rays.
• The Medical Assistant will now go get the Doctor.

Payments

With insurance, new patients can expect a copay (if required) plus a $100.00 deposit. The deposit will be applied to your balance after we receive payment from your insurance. This includes deductibles, coinsurance, and other charges not paid for by your insurance. Medicare, Medicaid, and VA healthcare patients are exempt.

Without insurance, the cost of a new patient appointment is $150.00. Procedures, tests, and additional services are extra. This includes ingrown toenail removals, x-rays, and night splints. You can call the office for an estimate.

Payment is due when you check in. We accept cash, checks, American Express, Discover, Mastercard, and Visa.

Insurance

Shoal Creek Foot & Ankle Center participates with most insurance plans including: Aetna, Ambetter, Anthem, Benefit Management, Blue Cross Blue Shield, Cigna, Cox Health Plans, Humana, MO Healthnet, Medicare, TRICARE, United Healthcare, and UMR. Please verify with your insurance provider that our clinic and/or our doctors are in-network with your specific insurance plan.

Missed Appointments

If you cannot be at your appointment or will be late, please call as soon as possible. We will do what we can to reschedule or fit you in. However, if you miss an appointment or cancel within 24 hours, you may be charged a $35.00 no show/late fee.

Request for Medical Records

All requests for medical records must be received in writing. Download and print the Request for Medical Records form below. Be sure to fill out the form accurately. If the patient is a minor (less than 18 years of age), a parent or legal guardian must sign the authorization. You may return the form to our office in person, electronically, or by mail.

Please allow 30 business days for us to process your request. If your request requires a fee, you will be notified before the records are sent.