New Patients

Patient Forms
Please download the patient information forms for the office location of your choice. For your convenience, you may type directly on to these documents. Once completed, simply print, sign, date, and bring them with you to your scheduled appointment. In order to expedite your first visit, please arrive at least 15 minutes early to allow our team to process your information.

Arlington Heights Office

• Patient Registration Form
• Medical History Form
• Financial Policy Form
• Notice of Privacy Practices - Signature Page
• Authorization for Disclosure

Wauconda Office

• Patient Registration Form
• Medical History Form
• Financial Policy Form
• Notice of Privacy Practices - Signature Page
• Authorization for Disclosure

Algonquin Office/Lake Zurich Office

• Patient Registration Form
• Medical History Form

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.


Mission Statement
Our practice mission is to cultivate and maintain satisfied patients. Patients have both technical and behavioral requirements. It is our obligation to service both.

Many patients feel a sense of anxiety or greater emotion when visiting a doctor's office. An understanding and compassionate response to their questions and concerns can comfort them and make their medical experience satisfying. As members of the podiatric team , we must consistently demonstrate a pleasant and caring appearance to our patients.

Obviously, there will be times when we feel frustrated and fatigued. Regardless, the patient should never be the object of our negative feelings. The lifeblood of this practice is based on goodwill. Regardless of how effectively we externally promote our practice, the basis for growth will depend on our patient referrals.

It is against office policy for a patient to perceive us as having a "bad day". There will be times when patients should be exercising greater control when relating to us. Regardless of a patient's behavior, we cannot lose our control. To maintain a calm caring demeanor is the sign of a true professional and trademark of this practice.

To fulfill this mission, we are committed to:

1. Listening to those we are privileged to serve.
2. Earn the trust and respect of patients, profession and community.
3. Exceed your expectations.
4. Ensure a creative, challenging and compassionate professional environment.
5. Strive for continuous improvement at all levels.

What to Expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familiarize yourself with the doctors. We look forward to your first visit.