Peoria Foot and Ankle Patients Forms and Resources

Shannon Office Manager

Easily Manage

Your Visit Online

All before your visit. New patients can fill out patient information, medical history, and insurance details, while existing patients can update their information.

After you request an appointment, our staff will confirm the details. Filling out your forms in advance helps us focus on your care. If you need help, we’re here for you!

Welcome, Patient!

At Peoria Foot and Ankle, our patients have access to all necessary forms and resources to make each visit smooth and efficient. Completing these forms ahead of time helps streamline check-in and ensures personalized care for all patients.

Our patient forms include intake forms, medical history, consent forms, and insurance documents. These forms are designed to collect accurate information so our team can provide the highest quality foot, ankle, and leg care.

All forms can be downloaded directly from this page, filled out at home, and brought to your appointment. Some forms are also available to complete online before your visit for added convenience.

In addition to forms, Peoria Foot and Ankle Patients can access educational resources and guides about common foot and ankle conditions, treatments, and preventive care tips to support ongoing foot health.

Preparing for your visit is easy when you review the guides and complete the necessary forms beforehand. This ensures your appointment is efficient and your provider has all the information needed to give the best care.

We also provide information for insurance, billing, and patient rights. Peoria Foot and Ankle Patients can review these resources anytime to understand what to expect and how to navigate the process smoothly.

start-to-finish

We'll take care of everything

PRIOR TO YOUR VISIT

To Get Started: Please fill out the following forms 

Step 1Patient Information & Financial Responsibility

Step 2Medical History

Complete Step 1 & 2 · For Your Upcoming Appointment

Peoria Foot & Ankle Patients completing forms online
STEP 1
STEP 1 - Required for Visit

PATIENT INFORMATION & FINANCIAL RESPONSIBILITY

Please take the time to fill out your patient forms before arriving. It takes a few minutes and allows us to have everything ready to go for your visit. 

Please proceed to Step 2 – Medical History

We look forward to seeing you soon!

(Required for Visit)

- Peoria Foot and Ankle
STEP 2
STEP 2 - Required for Visit

MEDICAL HISTORY

Please take fill out the second set of patient forms for your visit.

Medical history both family and your current history, helps us better understand your health background and tailor treatments to meet your needs. Simply complete the form below and submit.

Remember to Fill Out your Patient Information & Financial Responsibility Forms in Step 1

(Required for Visit)

Medical Record Release | Patient Education | Patient Portal | Printable Forms

Peoria Foot & Ankle patient forms for foot and ankle care
Peoria Foot And Ankle

Medical Records Release Request Form

We are committed to ensuring the confidentiality and security of your medical records. To facilitate the request of your records, please complete the following.

- Peoria Foot and Ankle
Peoria Foot And Ankle

Patient Education

Need to know more about your condition. We have a description of each condition and additional information to help you understand more. 

- Peoria Foot and Ankle
Online Bill Pay / Records

Patient Portal

Login to your patient portal to access your records and pay your bill online. 

- Peoria Foot and Ankle
Access To Print Medical Forms

Print PDF

Would you like to print your Patient Information Form and Medical History Form to fill out and bring with you on your visit? Click each option below to get your printable forms.

Are you ready for your appointment

Checklist Reminder For your Upcoming Visit

1

Patient Information & Financial Responsibility Forms Submitted

You should have received a message when you submitted this form. This is the confirmation that we are getting everything ready for your visit. 

2

Medical History Forms Submitted

This was the second set of forms needed for your visit. You will also have a confirmation message once submitted. 

3

Remember To Bring your ID & Insurance Card to your Appointment

We look forward to seeing your soon!