Patient Forms
New Patient Package (pdf)
If you are coming in as a new patient, or if you have
not been in for 3 years, please download and complete these forms prior to your
appointment. If you have completed the forms, please arrive 15 minutes prior to your
appointment. If you have not completed the forms, please arrive 30
minutes prior to your appointment.
Orthotic Financial and Insurance Information Forms (pdf)
These forms provide all the information you will need
on orthotic insurance and finance issues.
Includes step-by-step questions to determine whether your insurance
covers foot orthotic therapy and the percentage of coverage.
How to Wear Your Orthotics Form (pdf)
If you will be picking up your orthotics soon, read
this information before your appointment.
This document provides detailed information on how to best break-in to wearing
your orthotic devices.
Recommended Shoe List
The Foot and Ankle Center prepares a list of recommended shoes several times per
year. Don’t go shoe shopping without it. Includes recommended shoes, shoes that
work well with orthotics, OTC arch supports, socks, slippers and sandals.
Click here to learn how to download the shoe list.
Information Release Form (pdf)
Any physician must have a release from you to send a
copy of your records to another doctor.
If you would like your records sent to us, complete this form and send it to the
office that has the records you want sent.
If you would like us to send records to another doctor’s office, complete
this form and fax it to us at 206-860-0907.
It may take up to 7 business days to prepare and send the information and
charges may apply.
Matrixectomy (nail removal)
Post-operative Instructions (pdf)
Wart Excision Post-operative Instructions (pdf)
Pre-operative Instructions for
Hospital Surgeries (pdf)
All pages on this website © 2005-2010
Douglas Hale, DPM & Lawrence Huppin, DPM
Foot and Ankle Center of Washington, Seattle
The material provided on this web site is for informative purposes only.
If you need specific medical advice, please contact the office for an appointment.
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