If you are a new patient to our office, the links below are the new patient forms that will need to be filled out when you arrive for your first appointment. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival. Please call our office at 217-698-6228 if you have any questions at all. We will be happy to help!

• New Patient Form (Please fill out, sign and bring with you to appointment.)
• Notice of Privacy Practices (Please read and keep a copy for your records.)
• Acknowledgement of Privacy Practices (After reading Notice of Privacy Practices above, please sign and bring with you to appointment.)
• Financial Policy (Please read, sign and bring with you to appointment. Keep a copy for your records.)

If you need a copy of your medical record, please fill out the Release of Medical Records form below and either mail it to our office or email it to staff@prairiepodiatry.com.

Release of Medical Records.pdf

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