Eform: New Patient
Welcome! We're dedicated to providing exceptional footcare for people of all ages. Please help us get to know you better by providing the following information. Patients with serious medical emergencies should go to the nearest Hospital Emergency Department.
Once completed online, please click the “Submit” button on the form's bottom. Ensure you have been redirected to a confirmation screen before exiting. If you have not, there may be a required field that has not been filled out. We do not receive incomplete forms.
The initial visit fee is $80.00. Your first appointment is a combination of consultation and treatment. A complete examination and assessment of your feet, looking for lesions such as corns, calluses, warts, or range of motion/gait analysis examining foot function, circulation, sensation, color, and digital photos of both feet. Treatment options are then presented and discussed, your questions answered, and the next steps decided. Additional fees will be discussed prior to treatment.
Extended Health Insurance often covers routine foot care under Paramedical Services. OHIP does not cover Chiropody services. We will provide a receipt and necessary documents in the format of your preference, PDF or printed, at the end of each visit with all of the information your insurance company may require, which you may submit for reimbursement. 
If you have any questions or concerns, please call our office at 705-444-9929 or email us at tony@abbottfootclinic.ca 
The Team at Abbott Foot and Ankle Clinic
Abbott Foot and Ankle Clinic
10126 Hwy#126, East, Unit#3, Collingwood, ON.    L9Y1L5
705-444-9929   |   tony@abbottfootclinic.ca   |   www.abbottfootclinic.ca 
Please fill out with PATIENTS information ONLY
Your personal details. Please review them and make any necessary adjustments.
We would also like to learn about your preferences for receiving information from us! Our clinic takes patient confidentiality seriously. We respect your privacy. Your information is safe and secure with us.
Help us help you! Please answer the following foot questions:
Please provide current:
If you checked yes for Diabetes:

Additional Information:
Do you have any known allergies to:
Patient Physicians
This is the most important part of this intake form.
Patient Consent:
Please refer to our website for additional information and Patient Policies
We promise to treat your personal information with respect. Our privacy protocols comply with privacy legislation, the standards of the College of Chiropodists of Ontario and the law. Be assured that everyone in our office is committed to ensuring that you receive the best quality footcare.

We know your time is valuable…and ours is too!  Out of respect for our staff and our other patients, we ask that you give us at least 24 hours’ notice if you need to cancel or change your appointment.  This allows us time to offer that appointment to another patient who may be in pain.
There will be a $45.00 fee for all missed appointments and short cancellations.