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Click ‘Get Form’ to open it in the editor.
Begin by entering the patient's first name, middle initial, and last name in the designated fields. Ensure accuracy as this information is crucial for identification.
Fill in the home address, city, state, and zip code. This helps establish the patient's location for communication and billing purposes.
Provide contact numbers including home and cell phone. An email address is also required for electronic communications.
Complete the demographic section by selecting race and ethnicity from the provided options. This information may be used for statistical purposes.
In the medical history section, detail any current foot or ankle problems along with previous treatments or surgeries related to these issues.
Review all entered information for accuracy before submitting. Utilize our platform's features to save your progress or print a copy if needed.

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Can a podiatrist help with ankle issues?

Doctors of Podiatric Medicine (DPMs) are physicians and surgeons who practice on the lower extremities, primarily on feet and ankles.

Is it better to see a podiatrist or orthopedist for ankle pain?

Podiatrists can treat any common issue that affects your feet and toes, including: Ingrown toenails. Toe deformities. Foot and ankle injuries. Bunions. Plantar warts. Foot and ankle arthritis. Skin conditions affecting your feet and toenails. Diabetic foot problems.

Is there a difference between a podiatrist and a foot and ankle specialist?

Podiatrists provide care for bones, soft tissues and joints of the foot and ankle, but also the skin conditions and abnormal mechanics of the lower extremity, says John Giurini, DPM, Chief of the Division of Podiatric Surgery at BIDMC.

Is a foot and ankle specialist the same as a podiatrist?

A foot and ankle orthopedic surgeon performs complex surgical procedures, not performed by a podiatrist. There can be some overlap in what a podiatrist treats and what an orthopedic foot and ankle specialist treats such as the simpler conditions of sprains and strains.

Should I see an orthopedist or podiatrist?

Podiatrists can diagnose and treat any issues that affect your feet, ankles and lower legs including performing surgery. You might visit a podiatrist for a short-term issue, or they might be part of your care team that supports you while you manage a chronic condition.