In case you may have misplaced the information we gave you during your visit, we have provided a copy of the forms below.

 

 
New Patient Registration Forms

•please fill these forms out and bring them with you to your initial visit.


Arch and Achilles Tendon Stretches (Dr. Mehler)
Arch and Achilles Tendon Stretches (Dr. Galea)

Post-Op Nail Procedure Instructions (Dr. Mehler)
Post-Op Nail Procedure Instructions (Dr. Kaczander)
Post-Op Nail Procedure Instructions (Dr. Galea)

Runner's Strengthening Exercises
Purine Restrictive Diet (for Gout)
Post-Operative Instructions
Caring for your Cast
Orthotic Break-In Recommendations

 

 

Patient Privacy Notice
*under the Health Insurance Portability and Accountability Act of 1996 ("HIPAA")
we are required to maintain the privacy of your protected health information and
provide you with notice of our legal duties and privacy practices
with respect to such protected health information.

 


(you will need Adobe Acrobat Reader to view forms)
click above for free download

 

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Livonia
Michigan Foot and Ankle Center
Southfield
734-591-6612
www.MichiganFoot.com
248-353-9300
   
Copyright ©2004 Michigan Foot and Ankle Center, PC. Allen S. Mehler, DPM. Bruce I. Kaczander, DPM, Peter P. Galea, DPM & Joshua S. Faley, DPM