Rome, GA Foot Doctor
 

New Patient Forms

Welcome New Patients!

We always welcome new patients and try to offer convenient appointment times.

Please contact our office to schedule an appointment or use our Appointment Request Form.

Please bring your insurance card. We will need a copy of it for our records. Print and bring in your completed New Patient Information Forms or fax them to our office at (706) 802-1800. This step will save you time on your initial visit!

If surgery is scheduled at our office, please download the Surgery Packet.

Click on the links below to access the New Patient Form. After you click the link, a browser window will open. After it opens, click on the 'PRINT' icon on your Browser. After the form prints, fill it out and bring them into our office.

Patient Forms

New Patient Registration Form*
Surgery Packet*
Notice of Privacy Practices*

*You must have an Acrobat Reader to view the Acrobat files. If you don't already have Adobe Acrobat, you can download the Acrobat Reader Free.

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Free Podiatry Book Request for local Residents
Local residents can click here to receive your free book, "Healthy Feet For Life" written by Dr. Brian K. Middleton.
  Free Podiatry Book Request
Request an Appointment
Use the convenience of our website to request an appointment and save a few extra "steps"
  Request an Appointment
Ask-the-Doctor Videos
Click here for answers to your most frequently asked questions.
  Ask-the-Doctor Videos
New Patient Forms
Download and print our new patient registration and medical history forms.
  New Patient Forms
Laser Treatment For Toenail Fungus
This therapy focusing intense laser light beams right on the fungus.
  Laser Treatment For Toenail Fungus
Heel Pain Center
We have a large armamentarium of treatment options for dealing with heel pain.
  Heel Pain Center
Universal Ultrasound
We use sonography for diagnoses of plantar fasciitis, tendonitis, neuromas, cysts and certain tumors.
  Universal Ultrasound
Specialized Services
Dr. Middleton strives to provide the best possible foot care to his patients.
  Specilaized Services
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