New Patient Information

Welcome to Mid America Foot & Ankle Specialist Illinois. We're excited to help you with your foot and ankle care needs.

Prior to Your First Appointment

Please follow these important steps to ensure a smooth and efficient first visit.

Insurance Verification

Please call our office to verify your insurance coverage and benefits before your appointment.

Complete Forms

Download and complete all new patient forms before your visit to save time during check-in.

Gather Medical Records

Bring any relevant medical records, X-rays, or previous test results related to your foot/ankle condition.

Medication List

Prepare a complete list of all current medications, including dosages and frequency.

Arrive Early

Please arrive 15 minutes before your scheduled appointment time for check-in and paperwork review.

Download Patient Forms

Save time during your visit by downloading and completing these forms in advance.

New Patient Registration Form

Complete patient information and medical history form

Medical History Questionnaire

Detailed medical history and current symptoms form

Insurance Information Form

Insurance details and authorization form

HIPAA Privacy Notice

Privacy practices and patient rights information

Financial Policy Agreement

Payment policies and financial responsibility agreement

Diabetic Foot Care Form

Specialized form for diabetic patients (if applicable)

What to Expect During Your Visit

1

Check-in Process

Present your insurance card and ID. Review and sign any remaining forms.

2

Initial Assessment

Our medical assistant will take your vital signs and review your medical history.

3

Doctor Consultation

Comprehensive examination and discussion of your symptoms and treatment options.

4

Treatment Plan

Development of a personalized treatment plan and scheduling of follow-up appointments if needed.

Ready to Schedule Your First Appointment?

Our friendly staff is here to help you get started on your journey to better foot and ankle health.