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New Patient Information


 

Overview

Your first visit to our office establishes a vital foundation for our relationship with you. During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor.

Our Mission

Our friendly staff is dedicated to caring for you and your entire family's foot and ankle health and well-being. We take the time to create a personalized treatment for each patient and we offer a wide range of services. It is our goal to make your visit with us an extremely pleasant one.

What to Expect at Your First Visit

On your first visit, your doctor will review your medical history and evaluate your health. We will take any necessary xrays and we will explain to you whether or not you will require any treatment. Our team will be happy to answer any questions you might have.

What to Bring to Your Appointment

If you are a first-time patient, please plan on arriving early to complete a patient registration form. Please bring the following items to the appointment:

  • Insurance card(s)
  • Photo I.D.
  • List of all prescription and over-the-counter medications that you are currently taking
  • Any required co-payment
  • Pertinent medical and surgical history information
  • X-ray films that you may have
  • Completed patient forms

Patient Forms

Below are the Medical History and Privacy Policy forms you'll need to complete on your first visit. You can expedite matters by downloading these forms, completing them at home and handing them to our staff when you arrive for your initial visit to our office.

  1. New Patient Questionnaire - Dr. Cournoyer, Dr. Robert Grondin and Dr. Suzanne Grondin
  2. HIPAA Form - Dr. Cournoyer, Dr. Suzanne Grondin and Dr. Robert Grondin(Page 1)
  3. HIPAA From - Dr. Cournoyer, Dr. Robert Grondin and Dr. Suzanne Grondin  (Page 2)
  4. New Patient Questionnaire - Dr. Schaffer
  5. HIPAA Form - Dr. Schaffer
  6. Financial Policy - Dr. Schaffer

 


Financial Policy

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.

Directions

We are located at 123 Summer Street, Suite 550, Worcester, MA 01608.

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Our Locations

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