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New Patients

New Patient Forms

Provider-Patient Contact Consent Form

New Patient Registration Form

Welcome to JCMG Podiatry. Thank you for choosing our practice to address your foot and ankle needs! Our office is open Monday-Thursday 8am – 5pm and Friday 8am-1pm. Please feel free to contact us with any questions regarding your appointment.

In order to make your check-in process more efficient please arrive 15-30 minutes prior to your scheduled appointment time and bring the following information with you:

  1. All ‘New Patient’ paperwork
  2. Photo ID
  3. Insurance cards (view a list of the current insurances we accept)
  4. CD-ROM of any XRAY/MRI/CT scans regarding your foot and ankle care
  5. Pertinent Medical Records

Please be aware of the following information:

  1. Any Copay or previous balance is due at the time of service. Patients are financially responsible for the payment of all charges. Self-pay patients must make payment arrangements prior to visit. Charges not paid will be sent to a collection agency. In the case of default of payment patients may be responsible for legal interest on the balance due, as well as any collection costs, late fees and attorney’s fees incurred in the collection of this account.
  2. Please notify the office within 48 hours of the need to cancel your appointment so that the appointment time may be given to another patient.
  3. Cancellation Policy: Patients must give a 24 hour notice of cancellation on all appointments. Failure to do so may result in a charge.
  4. It is the patient’s responsibility to call their pharmacy for refill requests. If a prescription medication refill is required by a certain day please make sure your pharmacy faxes a timely request to our office. Refill requests will not be addressed on weekends or after hours.

Thank you! We look forward to treating you.

Sincerely,

JCMG Podiatry Physicians & Staff