Albemarle Family Foot & Ankle, P.L.L.C.

Specializing in Conservative Podiatric Care for Adults and Children

About Our Practice

Patient Office Hours

Fees & Services

FAQ

Meet the Team

Patient Forms

Contact Us

CLICK HERE to request an appointment.

2025 RECOMMENDED SHOE LIST (RMRS)
New Patient Forms

Please print and bring these completed forms - along with a photo ID - with you to your first scheduled appointment.


Demographics Form
Medical History Form

Please print, review, and sign these consent forms to bring with you on your first visit.

Thank you!!


General Consent for Care & Financial Agreement
 
HIPAA
Patient-Specific Forms

Please print and complete these forms - if applicable.


 
Dancers only
Workers Comp only

Tips for your first visit:

  • Be sure to bring a photo ID with you.  
  • It is helpful to have a printed list of all medications - including the dosage -(prescription and over-the-counter) that you may be taking.
  • If you wear orthotics or inserts in your shoes, be sure to wear or bring them with you.

Notice of Privacy Practices
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