New Patient Forms

Before you see a Keir Foot & Ankle specialist, we will need some information from you. Please use the electronic forms on this page to record your medical history.* 

  1. Download the two forms.
  2. Fill out each form, either electronically or by hand.
  3. Bring a printed copy of your completed forms to your appointment.

*If you do not have access to a computer, you will need to arrive 30 minutes before your appointment so that you can complete the forms.