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Gabriel Lazar, DPM

Foot and Ankle Specialist

Se Habla Español

New Patient Forms

We know you have many choices when choosing a Podiatrist, therefore, we have made requesting an appointment a simple process via our Web site. If, for any reason, you cannot keep a scheduled appointment or will be delayed, please call as soon as possible. All patients will be seen within 24 hours.

Patient Forms
Please print and fill out the New Patient forms so we can expedite your first visit.

pdf podiatry patient form downloadNew Patient Forms (English)

pdf podiatry patient form downloadNew Patient Forms (Spanish)

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

  • Patient's insurance card
  • List of current prescriptions and/or over-the-counter medication, including dose and frequency
  • Information about patient's medical and surgical history
  • Recent test results, x-rays, or relevant records

Our office accepts a variety of different HMO's, PPO's and other health plans, including the following:

  • BC BS
  • BC BS Federal
  • BC BS HMO (Referral required)
  • United Healthcare
  • United Healthcare Select (Referral required)
  • First Health
  • Aetna
  • Cigna
  • Unicare
  • Medicare
  • Evercare
  • Secure Horizons
  • Humana PPO and HMO (referral required)
  • Wellmed Humana
  • Wellcare Health Plans
  • Medicaid (Traditional, Superior, El Paso First) referral required
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