Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
"Great staff, always so friendly and helpful! Definitely would recommend them to anyone having any issues related to their feet."
Your experience with us during your visit to Silicon Valley Podiatry Group is vitally important to us. We want to make sure you have time to get to know your doctor, and your doctor has time to get to know you—including important background information and medical history.
In order to make your first visit as smooth as possible, we provide the following resources for you to review and complete ahead of your appointment.
Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente
Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)
Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)