New Patient Form — Canadian Foot Clinic & Orthotic Centre — St. Catharines Registered Chiropodist

Save time at your first chiropody visit: print, complete and email your New Patient Form or arrive 5–10 minutes early to fill it out in‑office. OHIP does not cover chiropody

Download our New Patient Intake Form:

Please print and fill out both pages to speed up your intake during your first visit to our office. Scan and email your completed forms to: info@CanadianFootClinic.com OR bring your completed forms to your first office visit.

For your convenience, we can make a copy of your medication and allergy list for our records.

Alternately, please arrive 5-10 minutes before your appointment to fill in the New Patient Form in-office.

If available, please bring the CD or reports of your foot & ankle X-rays or other imaging studies for your first visit.

(Note: Referrals are not required but certainly appreciated)

OHIP does not cover chiropody services.

See Insurance Information for more details