Patient Forms

All new patients will need to fill out the below forms prior to their initial patient visit. Filling these out ahead of time will allow more time to be spent discussing your foot/ankle-related problem(s). The medical history form will be reviewed at the time of the appointment with you and any questions regarding the other forms can also be discussed further at that time.

Insurance: Dr. Falk does not accept insurance and has opted out of Medicare; however, many of the services may be covered, or partially covered, by insurance companies. You are free to consult your insurance company at any time to get information regarding coverage. After your visit, you can also submit your service invoice to your insurance company for potential reimbursement.



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