Welcome to North Fork Podiatry & Three Village Podiatry. Your Foot & Ankle Specialists serving Southold, East Setauket & Riverhead, NY.
Patient Registration - New Patient Forms
You can download the new patient packet here:
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What information to bring
Being well-prepared for you appointment will ensure that the doctor has all of the needed information to provide the best possible care for you. It will also help relieve any unnecessary anxiety you may be feeling
Please remember to bring the following items to your appointment:
Health insurance cards
Your primary care doctor’s contact information
A list of any medications you are taking (prescription and over-the counter)
A referral from your primary care doctor (if required by your insurance carrier)
Any previous x-rays, MRI’s other test results relating to any past foot health conditions
If you are a diabetic – It would be helpful to either bring or have your primary care physician fax me a copy of your most recent blood work