New Patient Forms

Welcome to our practice. We are excited to meet you and treat your foot condition. For your initial appointment, you must bring the following with you to our office:

  •  your photo ID
  •  your insurance card
  •  a form of payment (cash, check, credit card) with you to the office. 

Please call our office to confirm we accept your insurance. Please also be aware that you may have a co-payment for your visit.  

If your insurance carrier requires a referral from your primary care physician, please confirm with them that your referral has been faxed to us prior to your visit.  This is your responsibility.  

Our fax number is:  401-351-2378. 

If you must cancel your appointment, we require a 24 hour notice.  Patients who do not call the office to reschedule their appointment, or cancel prior to the appointment, will be billed a $75.00 charge.  Please call us at 401-861-8830.  Thank you.

These forms are for you to complete PRIOR to your visit.  You do not need to print anything out, as the forms automatically upload into our database.  This is a secure portal.  If you do not complete these forms prior to your initial visit, then you will need to arrive at our office 10 minutes before your scheduled appointment to complete paperwork.  

Instructions for use:

  1. Use your computer’s internet browser to go to: https://eportal.icssoftware.net
  2. Click the “create new account” link on the Login Page
  3. Enter your following authorization code (case sensitive)
  4. Answer the four questions and click “verify”
  5. Complete the account registration by supplying a unique username and password
  6. Click the “create” button

Congratulations!

You have successfully created your account and added your provider.

All information communicated on the patient portal is confidential. You should review your healthcare record. If you have any questions or concerns you should consult with your provider.