New Patient Forms
Complete the confidential medical, insurance, medication, and health-history information requested before your first visit.
Official office PDF · 6 pages
Prepare for your visit
Patient Forms
Review and download the official forms provided by Wasatch Foot & Ankle Center before your visit.
Consent to Treatment & Financial Agreement
Review consent, release-of-information, insurance payment, cancellation, no-show, and financial agreement policies.
Official office PDF · 1 page
Notice of Privacy Practices
Review the office notice about protected health information, permitted uses, disclosures, and your HIPAA rights.
Official office PDF · 1 page
Financial Hardship Form
Request a financial hardship review. The office recommends submitting sensitive supporting documentation in person.
Official office PDF · 2 pages
Protect your health information
These documents contain sensitive health, insurance, and financial information. Do not submit completed forms through the website request form or ordinary email. Call the office for secure intake instructions.
Need help before your visit?
Our Heber City team can answer questions about forms, insurance, and what to bring.
(435) 657-0329