1712 Picasso Avenue, Suite C
Davis, CA 95618
(530) 753-6280
CONDITIONS AND TREATMENTS
NEW PATIENTS
Mission Statement
Our practice is a dedicated team, working together to realize a shared vision of uncompromising excellence in podiatric care. To fulfill this mission, we are committed to:
- Listening to those we are privileged to serve.
- Earn the trust and respect of patients, profession and community.
- Exceed your expectations.
- Ensure a creative, challenging and compassionate professional environment.
- Strive for continuous improvement at all levels.
Patient Forms
Below are links to the paperwork required for new patients to fill out. We highly recommend that you print these forms to fill out and bring in with you to your appointment. This will expedite the check-in process and ensure that the doctor will be on time to see you. If you do not fill this paperwork out ahead of time, please arrive 15 minutes prior to your scheduled appointment time to begin this process. Please be sure to have your insurance card(s) available and be prepared to pay your copay.
We have also provided a medical records release form if you need to request your records from us or from another doctor to be sent to us. Please complete the form and drop it off or mail it to our office.
New Patient Paperwork
- Patient Demographic Information
- Medical History
- Acknowledgement of Privacy Practices
- Notice of Privacy Practices (HIPPA)
Release of Medical Records
In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click here to download it.
Driving Directions
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