Peninsula Podiatry Patient Forms

New Patient Intake Form for Peninsula Podiatry – (PDF)

Peninsula Podiatry Welcome Flyer- (DOC)

Peninsula Podiatry HIPAA Policy and Privacy Information- (PDF)

COVID-19 Risk Informed Consent – (PDF)

Click on the link to open the file in a browser window.

Save a form to your computer:
Right Click > Save Link-Target As

Please print and fill out prior to your first visit.

Foot Conditions We Treat

  • Heel Pain
  • Bunions
  • Joint Pain
  • Ingrown Toe Nails
  • Burning in Feet
  • Tingling/Sharp Foot Pain
  • Shooting/Electrical Foot Pain
  • Achy/Throbbing Pain
  • Foot Swelling
  • Thick or Deformed Toe Nails
  • Lumps and Bumps
  • Difficulty in Walking
  • Frequent Falls
  • Skin Growth
  • Rash
  • Itchy Toes/Feet
  • General Diabetic Foot Care

Insurances Accepted

  • AARP (Supplemental
  • Aetna
  • Cigna
  • Group Health (PPO & POS only)
  • KPS
  • Mailhandlers Benefit Plan
  • Medicare Part B
  • Premera Blue Cross
  • Regency Blue Shield
  • Tricare West Region
  • Tricare / Medicare
  • United Healthcare
  • Washington L&I
  • First Choice Network
  • Meritan
  • Not Listed? Call to verify