Call: (360) 256-1777
Patient Information

Patient Forms

If you are a new patient to our office, please view our links below to download our various forms that will need to be filled out when you arrive at our office. Printing them, filling them out and bringing them with you will allow us to attend to your medical needs more quickly than completing them on your arrival.  Thank you and please contact our office if you have any questions at all.

Established patients wishing to obtain medical records from Ankle & Foot Clinic, PS, for HIPAA compliance, please complete the following document:

Payment Options

All co-pays & Deductibles must  be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-pays & deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payments & deductibles at each visit.

For your convenience, we accept cash, personal checks, money orders, and most major credit cards. Payment is expected at the time services are performed.


We will submits your claims & assist you in any way we reasonably can to help you get your claims paid. Your insurance company may need you to supply certain information directly. It is your responsibility to comply with their request. Please be aware that the balance of your claim is your  responsibility whether or not your insurance company pays your claim. Your insurance benefit is a contract between you and your insurance company; we are not party to that contract.

Ankle & Foot Clinic, PS is a member of most Major Insurance Groups/Networks. We will bill "assigned" to any insurance carrier we are in network with.

*Some Plans require a referral from your Primary Care Physician (PCP) to a specialist. Be sure to Check with your plan on referral requirements prior to arranging an appointment

  • Aetna Healthcare
  • All Blue Cross Plans participating in the Blue Card program
  • Cigna Healthcare
  • Molina Healthcare
  • First Choice Health
  • Healthnet (including Medicare Advantage)
  • LifeWise of WA/OR
  • Managed Healthcare Northwest (MHN)
  • Medicare
  • ODS/ Moda Health
  • Pacificare of Oregon
  • Premera BC of Washington
  • Providence Health Plan
  • Regence BC Of Oregon (including Medicare Advantage)
  • Triwest
  • United Healthcare (including Medicare Advantage)
  • Washington State Medicaid-Apple Health

    Frequently Asked Questions

    Click Here