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Patient Forms

During the first visit, Dr. Ferrelli will obtain important background information, like your medical history, and give you time to get to know her as a doctor.  She accepts most insurances.

Patient Forms
Please print and fill out the New Patient forms so Dr. Ferrelli's staff can expedite your first visit.

pdf podiatry patient form downloadPatient History & Physical Information Form

pdf podiatry patient form downloadPatient Questionnaire

pdf podiatry patient form downloadOffice Policy Form (Please read & sign)

pdf podiatry patient form downloadPrivacy Notice (Please read & sign)

Please arrive early so that Dr. Ferrelli's staff can complete your initial paperwork. Also, please bring the following:

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

Insurance and Payment Information

You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans Dr. Ferrelli accepts, please call (716) 250-9257. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

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