New Patients

Your first visit to Foot & Ankle Center of Illinois establishes a vital foundation for our relationship with you. We are privileged to serve you and committed to provide you with excellent medical care and service. During the first visit, we need to obtain important background information to establish your electronic medical record . In order to streamline this process, please complete the enclosed forms in advance and give them to our receptionist when you arrive for your appointment.

Our practice will work with you to relieve your pain and discomfort and to maximize your full function as soon as possible. Our goal is to heal, restore, and rejuvenate your quality of life. We are committed to exceed your expectations and will strive to continuously improve on all levels for your benefit.

 

INSURANCE AND BILLING:

Our office accepts most insurance plans, including:

  • PHAI BCBS HMO
  • Personal Care HMO/PPO
  • Coventry HMO/PPO
  • Healthlink HMO/PPO
  • Cigna HMO/PPO
  • United Healthcare HMO/PPO
  • Blue Cross Blue Shield HMO/PPO
  • Aetna HMO/PPO
  • Humana HMO/PPO
  • Medicare
  • Health Alliance -Select Plans (Springfield & Decatur)

IMPORTANT items needed to expedite registration:

  • Photo Identification
  • Date of Last Appointment with Referring Physician (Medicare patients only)
  • Medical Insurance Card and Co-pay (if needed)
  • X-Ray Report or Disc (if needed)
  • Health History Questionnaire (complete)
  • Acknowledgement of Receipt of Privacy Practices (signature)
  • Financial Policy (signature)
  • Illinois Laser Center Questionnaire

Please feel free to call us if you have any questions. Thank you in advance for choosing us and helping us streamline your registration. My staff and I look forward to meeting you.

Patient Forms
Please print and fill out these forms so we can expedite your first visit:

In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What to expect
Being well-prepared for your appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It also will help relieve any unnecessary anxiety you may be feeling. Educate yourself on your symptoms by reviewing the content on this Web site. Also, take some time to review our staff page and familarize yourself with the doctors. We look forward to your first visit.

To request appointment availability, please fill out the form below. Our scheduling coordinator will contact you to confirm your appointment.

Request Appointment Here

LOCATION:
Foot & Ankle Center Of Illinois

2921 Montvale Dr.
Springfield, IL 62704
Phone: 217-787-2700
Fax: 217-787-2715

HOURS:
Monday - Friday: 8am - 5pm
Saturday & Sunday: Closed


LOCATION:
St. Mary's Hospital
1750 Building
1750 E. Lake Shore Drive, STE LL2
Decatur, IL 62521
Phone: 217-787-2700
Fax: 217-787-2715

HOURS:
1st Monday: 08:00 AM - 04:15 PM
2nd, 3rd, & 4th Monday: 08:00 AM - 11:30 AM
Wednesday: 08:00 AM - 11:30 AM


LOCATION:
Carlinville Area Hospital
20733 North Broad Street
Carlinville, IL 62626
Phone: 217-787-2700
Fax: 217-787-2715

HOURS:
2nd & 4th Thursday: 08:00 AM - 05:00 PM


LOCATION:
Shelby Memorial Hospital
200 S. Cedar Street
Shelbyville, IL 62565
Phone: 217-787-2700
Fax: 217-787-2715

HOURS:
1st, 2nd, & 4th Wednesday: 01:00 - 04:15 PM


LOCATION:
Kirby Medical Center
1109 N. State St
Monticello, IL 61856
Phone: 217-787-2700
Fax: 217-787-2715

HOURS:
3rd Monday: 01:00 - 04:15 PM


LOCATION:
Taylorville Memorial Hospital

201 E Pleasant St
Taylorville, IL 62568

Phone: 217-787-2700
Fax: 217-787-2715

HOURS:
2nd & 4th Monday: 01:00 PM - 04:15 PM


LOCATION:
Fields Wright Medical Facility

2 W Adams St
Sullivan, IL 61951

Phone: 217-787-2700
Fax: 217-787-2715

HOURS:
2nd Wednesday: 01:00 PM - 04:15 PM