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Call Us Today!
(234) 542-5179
Call Us Today!
(234) 542-5179

New Patients

New Patient Information

At Falls Foot and Ankle Clinic, we strive to make your visit not only pleasant, but efficient.  The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can. Our staff will assist you with any questions you may have on the day of your visit. 

Please print out and complete the appropriate forms:
File

New Patient Registration Form

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File

Authorization For Release of Information 1

Download File
File

Authorization For Release of Information 2

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File

Acknowledgement of Receipt of Notice of Privacy Practices

Download File

Call Us Today At ♦ (234) 542-5179

YP Reviews

We moved! Our new office is directly accross the street from our old office.

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  • Contact Information

    Falls Foot & Ankle Clinic
    436 Graham Rd
    Cuyahoga Falls, OH 44221
    Phone: (234) 542-5179
    fallsfootandankle@gmail.com

    Business Hours:

    Monday-Friday 8:30 a.m.-4 p.m.

    Payment Options