PATIENT INFORMATION
BLANKEN FOOT AND ANKLE LLC
Welcome to the Blanken Foot And Ankle LLC in Silver Spring, MD
What to Bring to Your Appointment
We ask that all new patients arrive a minimum of 20 minutes prior to their scheduled appointment in order to complete the registration process. Patients who have already completed the registration forms (by accessing them through our web site or by picking them up at our office) need only arrive 10 minutes prior to their scheduled appointment time.
Patient's Health Insurance Card(s)
Photo ID
Primary Care Doctor's name and telephone number
Referral From Your Primary Care Doctor (If Required By Your Insurance Carrier)
List of current prescriptions and/or over-the-counter medication, including dose and frequency
Information about patient's medical and surgical history
Any Previous X-Rays, MRIs or Test Results Relating To Any Past Foot Health Conditions. Recent medical records or x-rays will be helpful and may save you time and charges if you are seeking a second opinion or transferring your care
Insurance
Blanken Foot and Ankle LLC is accepting new patients and most insurance plans are accepted. Please call our office regarding your insurance questions. Insurance verification is recommended prior to your appointment.
Cancellations
Scheduling and Cancellations: Please call our office to schedule an appointment. If you are unable to make your appointment, please notify us 24 hours in advance.
Forms for Your Appointment
To save time, you can fill out your form before your scheduled visit.
Click on the button below to download the convenient PDF fillable form to be completed for your visit. Fill out the form in its entirety. Please note: you will need Free Adobe Acrobat Reader or Preview on a Mac to view and type into this form
NEW PATIENT FORM - If you are a New Patient Please print and fill out these forms so we can expedite your first visit:
