First Time Arrival Checklist - cfac.net
First time Arrival Checklist Items to bring: Registration Form completed Consent to Treat/Acknowledgement of Financial Responsibility/Notice of Privacy Practices Acknowledgement Form Signed medical History Form completed Vascular/Neurological Screening Form completed if one of the following applies: o Diabetes o Over 65, (50 with diabetes). o Smoke o History of known heart disease Personal Representative Authorization Form completed (optional see form for details). All insurance cards and an identification card with a your photo Up-to-date list of all medications After Arrival : We are required to have you sign an acknowledgement that you have received the Notice of Privacy Practices that was included with this packet. Welcome to Centers For Foot & Ankle Care! Our Mission: The podiatrists at Centers For Foot & Ankle Care are dedicated to providing you the highest quality foot care.
Surgery Cancellation Policy : Surgeries require careful planning and coordination among our office, the surgical facilities, and other medical specialists who may be involved in your care such as the anesthesiologist and surgical technicians.
Download First Time Arrival Checklist - cfac.net
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