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Lockport Foot Care, PLLC
Harry I. Zirna, DPM

New Patients Forms

podiatry patientsAt Lockport Foot Care we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor.  Our podiatry office accepts most insurance plans.  Please call our Lockport office (716) 434-3338 or Medina office (585) 798-1515 to find out if we accept your insurance plan.

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

pdf download New Patient Form  pdf download Legal Disclaimer

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

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 we accept, please call our office (707) 769-8481. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

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