New Patients

New Patient Information Form

If you are a new patient to Foot & Ankle Associates of Cleveland, you may download the Patient Intake Form above and complete it before your first visit. Bring the completed form to your first appointment in order to save time in the waiting room.

Expectations for your first appointment:

  • Arrive 10 minutes early in order to ensure you have the appropriate time to check-in and complete any additional paperwork.
  • Make sure to bring your valid photo identification and insurance cards.
  • If your insurance company is not listed, please contact Foot & Ankle Associates of Cleveland and our staff will perform a complimentary benefits verification for you.
  • It is required that payment for services such as unmet deductibles, co-insurance, and co-payments must be paid at the time of service.

Accepted Carriers

  • We Accept Most Insurance Carriers
  • Aetna
  • Antares
  • Anthem
  • Buckeye
  • Caresourse
  • Cigna
  • Health Span
  • Molina
  • Medicaid
  • Medicare
  • Medical Mutual
  • Palmetto
  • Paramount
  • United Healthcare

Accepted Payments

  • Cash
  • American Express
  • Visa
  • Mastercard
  • Debit