Patient Forms & Policies

Patient Portal

To access your existing account, please login to the Patient Portal.

Pay Online

Easily make a payment to your bill online using your bank account or credit card.

Pay My Bill


During your first visit at Advanced Foot & Ankle Care Centers, we require certain forms to be completed. These forms provide our staff and physicians with important background information and your medical history.

You can save some time at your first appointment by printing out and completing the patient forms below, in advance.

Medications and Refills

When calling for a medication, please have your pharmacy telephone number ready. Refills for controlled substances and pain medications will not be phoned in after office hours or on the weekends.


Many insurance plans require a Primary Care Physician referral in order to be seen by a
Specialist. It is your responsibility to ensure that your Primary Care Physician provides us with a referral number prior to the visit.

Are you a referring physician? We always welcome new patients and offer same-day and next-day appointments. Get more info and download our referral form here

Fees and Deductibles

We ask that you pay any Co-pays and deductibles at the time of your visit. Payments may be made by cash, check, credit card or debit card. Please be sure to provide us with current insurance information/card that will allow us to file your claim properly and in a timely fashion.


We are participating providers for many insurance plans, HMO’s, PPO’s and other groups and will gladly file with your insurance company. Should you have any insurance or billing questions you can call the billing office for Advanced Foot & Ankle Care Centers at (615) 630-7436.