Patient Forms

Please consider using our secure Online Registration option to help save time and streamline your upcoming appointment.  However, if you would prefer to use paper forms, continue below.


If you are a new patient or haven't seen us for awhile, download, complete and print our Patient Registration Form below.  Also take time to read our financial and privacy policies.  


Please arrive 30 minutes before your appointment time so we may enter your information and finalize your registration.     

If you are unable to make your appointment, it is important that you contact us at least 24 hours before your scheduled time so we can make other arrangements.

We look forward to seeing you soon!

Registration Forms

Please download, complete, print and bring with you to your appointment.  

Click to review our Financial Policy.  

Click to review our Privacy Policy.  

Other Forms

Is routine foot care covered by Medicare?

A useful form if you would like to check insurance benefits for orthotics.  

320 McKenzie Ave., Ste. 102

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Copyright 2020 by Council Bluffs Foot & Ankle Care