Get the free Shelby Foot Patient Forms

Shelby Foot & Ankle 50505 Schoenberg Road, Suite 230 Shelby Township, MI 48315 (586) 5803728 www.shelbyfoot.com 1. PATIENT INFORMATION 2. INSURANCE Date: Who is responsible for this account? SS/H/C/Patient

How to fill out shelby foot patient forms

How to fill out Shelby Foot patient forms:

1. Start by carefully reading the instructions provided on the form. Make sure you understand what information is being asked for and how to accurately complete each section.
2. Begin by providing your personal information, such as your full name, date of birth, address, contact number, and email address. Double-check that all the details are correct and legible.
3. If applicable, you may need to provide information about your primary care physician or any other healthcare providers you are currently seeing for related conditions. Include their names, addresses, and contact information.
4. Next, you may be asked to provide your medical history. This typically involves disclosing any past surgeries, injuries, or illnesses that may be relevant to your current foot condition or treatment.
5. Be prepared to provide a thorough description of your current foot condition, including when the symptoms started, any factors that aggravate or alleviate the pain, and any previous treatments or therapies you have undergone.
6. Some forms may require you to provide detailed information about your insurance coverage. This includes your insurance provider's name, policy number, and any applicable authorization codes.
7. Take your time to carefully review the completed form before submitting it. Make sure all the provided information is accurate, legible, and complete. If you have any doubts or questions, don't hesitate to seek clarification from the healthcare facility's staff.

Who needs Shelby Foot patient forms:

1. Individuals who are seeking medical treatment or consultation from the Shelby Foot clinic or healthcare facility.
2. Patients who have a foot condition that necessitates specialized care or diagnosis.
3. People who want to provide their medical history and personal information to the Shelby Foot clinic in order to receive appropriate treatment and support.

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