Patients Forms & Documents

We offer various holistic treatments, products and services to compliment our traditional protocols

Have An Appointment?

When you schedule an appointment please download the patient forms off our website and add the additional form if you are an athlete, dancer or runner. Please come 10-15 min early in order to complete paperwork and registration. Please adjust your schedule to allow at least one hour for your initial visit at our office.

We make courteous reminder calls generally within 1-2 days prior to your appointment. Due to occasional voice mail issues patients may not receive the call. Regardless of the receipt of a confirmation call, patients are expected to keep their scheduled appointment time. There is a $50.00 fee for missing your appointment or for cancellations less than 24 hours in advance. We value our patients and want to accommodate them as quickly as possible. Please be courteous and call to cancel at least 24 hours in advance. Giving 24 hours’ notice gives our staff the time needed to offer any cancelled appointments to those on our waiting list.

PARKING

Our Gurnee practice is at Gurnee Podiatry & Sports Medicine at 351 South Greenleaf Street, Park City. This practice in the northern Chicago metropolitan area helps us serve the Lake County townships of Warren and Waukegan. We have a large on-site parking lot for the convenience of patients and their families.

Our Chicago podiatrists' practice is at Sports Medicine Associates, located at 401 West Ontario Street, in the River North Gallery District. Take advantage of ample parking in the SP+ Parking station on the next block, or catch the number 37 bus to the Orleans & Erie station just a two-minute walk away.

APPOINTMENTS

We encourage all patients to schedule visits by appointment. We request that you call in advance so that we can reserve an appointment time for you. If you find it necessary to call after hours, the voice mail will record all evening messages and the office will retrieve and return the calls on the next business day.

INSURANCE

We make every effort to keep down the cost of your podiatric care. You can help by paying your co-pays or known balances upon completion of each visit. Our office will gladly give you a detailed receipt and file the claim form to your insurance on your behalf. Some companies apply fixed allowances for certain procedures and others pay a percentage of the charge. If we are in network with your insurance plan, we will deduct the insurance adjustments prior to sending you a bill. It is every patient’s responsibility to understand their policy and its coverage details. You are responsible for any deductible amount, co-insurance or co-pay amount not paid by your insurance company. Any supplies that are dispensed are to be paid for at the time of service. Our office will send out detailed billing statements monthly, and all balances are to be paid immediately and/or at the next office visit if undergoing current treatments. Our office is in network with many insurance plans. We ask that every patient still check and confirm with their insurance about all coverage polices, as some have restrictions and maximums.

Please Bring The Following Items To Your Appointment:

1. All registration forms
2. Photo ID
3. Current Insurance card
4. Referral forms (if applicable to your insurance)
5. Shorts or very loose athletic pants that come above the knee
6. Athletic shoes; dance/pointe shoes, running, cleats etc.
7. Previous X-Rays, MRI films
8. Old orthotic devices (even if you are not currently wearing them)
9. Anything else that may aid in your consultation and treatment.

INSURANCE: Our office will submit a claim to your insurance company for any services rendered. When your insurance contracts with our office, they are legally obligated to pay our office in a timely manner. After 90 days, if the claim is not paid to our office after proper billing procedures have been followed, the balance becomes your responsibility. Our office participates with many insurance plans, network participation by our office does not mean services are covered by your plan. It is the member's responsibility to understand your insurance benefits; all co-insurance amounts, deductibles, non-covered items and co-pays are always your responsibility. Please note, for certain members, your health plan will begin issuing payment once your deductible has been met. Unless your insurance pays at 100% you will be responsible for any remaining co-insurance applied by your plan. We are required to bill you for any amounts deemed patient responsibility and nothing else. All pre-authorizations, referrals and/or second opinions are your responsibility to obtain. You are responsible to update our office with any changes to your current policy.

When you schedule an appointment, please download all the patient forms. You can send them to [email protected] (Tittle email "New Patient Paperwork") or print them out and bring  with you at the time of your appointment. There is a $50.00 fee for missing your appointment or for cancellations less than 24 hours in advance.