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  New Patients  
     
  To make your first appointment as easy as possible, we are offering you our intake forms online for you to print, fill out, and bring to your initial appointment.

Form is in PDF format.

Intake Form










Instructions for Downloading PDF forms:

1. If you have Adobe Acrobat Reader installed on your machine. If you want to view the document immediately, just click on the appropriate link above. It will open up a new browser window and the form will appear. If you want to save the form at this point, click on the diskette icon in the upper left corner of the menu bar.

If you want to save the document without viewing it, RIGHT mouse click on the appropriate link below. Choose "Save Target As" and select the location in your computer or network that you would like to save the document.
In order to open up the saved document, start your Adobe Reader and open the appropriate file.

2. If you DO NOT have Adobe Acrobat Reader installed on your machine. Click on the Adobe "Get Acrobat Reader" icon on this page. Follow their instructions to download the program. Once loaded, follow the instructions above in #1.

 


  
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Central Podiatry • 125 E. Central Road, Arlington Heights, IL 60005 • (p) 847.255.0330
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