Before You Arrive

New Patient Information Form

Reason For Visit
Have you had a foot examination before?
Foot Related Conditions
Select any areas in which you have medical problems that have been diagnosed
Please list any medications (prescribed or over the counter)
Do you have allergies?

Office Policy and Privacy Policy

OUR PLEDGE TO YOU: The Chiropodist and staff at this clinic will make every effort to give you the best quality care in a professional and timely fashion.

TIME IS PRECIOUS: We will do our best to see you at your scheduled appointment time. Therefore, we expect that all patients be on time for their scheduled appointments. If you are late you may have to be rescheduled for another date and time.

APPOINTMENTS ARE PRECIOUS: Our office staff sends email and text reminders, however, it is your responsibility to keep track of your appointments and arrive at our office for the scheduled date and time. Patient’s calling to cancel an appointment must give 24 hours notice or the full fee for the appointment is charged.

PRIVACY POLICY: Due to the privacy act, our office requires your permission to discuss your condition or treatment information with any of the parties listed below.

I consent to the staff of the North Bay Foot & Ankle Clinic releasing information about my treatment at the clinic to the following parties:

Reason For Visit

Request An Appointment Form

Please note that our services are not covered by O.H.I.P. and we have a fee for service. You will be contacted by phone by one of our staff to schedule an appointment date.

FAQs

Is my visit covered by O.H.I.P?

No, unfortunately our services are not covered by O.H.I.P.

Do I need an appointment?

Yes, visits to our office are by appointment only.

Is there wheelchair or handicap access?

Our current location is ground level, and provides wheelchair access to front and back of the building.

Where is parking located?

Our building offers free parking.

What is your cancellation policy?

We require 24 hours notice for appointment cancellation.

What do I need to bring to my appointment?

When you come to our office for your appointment, please bring footwear with you, as we would like to see the types and style of the shoes you wear the most. Ladies, please remove any toenail polish you may be wearing before arriving.

How do I make a payment?

Our office accepts cash, Visa, MasterCard and debit cards. We do not accept cheques. Payment is due the day of your visit, and you will be issued a receipt that you can use for income tax purposes or send in to your health insurance provider.

Do I need a referral?

Medical referrals are not necessary for you to book an appointment. However, some private health care plans will not reimburse your visit fee unless you have been referred by your family physician.

Is my visit covered by my private or work health insurance plan?

Possibly. Most insurance companies do have coverage for visits to a Chiropodist, as well as for orthotics and sometimes footwear. We suggest a patient contact their insurance provider to confirm their coverage, as well as inquire if they require a doctor’s referral before their visits will be reimbursed. You will pay us for your visit, and receive a receipt that you can send into your insurance company.

If you have coverage through Green Shield insurance, or the Veterans Affairs Canada, we can bill them direct. For Green Shield patients, please bring your insurance card with you to your appointment. For VAC members, we will need your card to confirm coverage.