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Dallas Metro / North Texas
(214) 710-1028

New Patient Forms

Insurance and Payment

Elite Foot & Ankle accepts Medicare and a variety of private insurance PPO's, HMO's and other health plans. Please call our office to verify acceptance of your insurance carrier. We will also obtain information on benefits from your insurance carrier. Please contact us to verify your insurance if you are unsure.

Copays and or Deductibles are due at time of service. Payment methods accepted are cash, checks, money order, and credit cards (Mastercard, Visa, Discover, American Express).

Patient Forms
Please print and fill out the New Patient forms so we can expedite your first visit.

pdf podiatry patient form downloadDisclaimer

pdf podiatry patient form downloadFinancial Policy

pdf podiatry patient form downloadPrivacy Practices

pdf podiatry patient form downloadInsurance Information

pdf podiatry patient form downloadMedical History

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

  • Insurance Card
  • Photo ID
  • Information on medical & surgical history
  • Recent lab tests, imaging studies, relevant records if any

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