PATIENT REGISTRATION AND POLICIES

 

We are pleased to welcome you as a patient. At CWPS, we always strive to provide the best medical care for your feet and ankles, and responsive, compassionate patient care. Your privacy and convenience are important to us. Thank you for choosing CWPS.

If you are a New Patient, Please click on EACH one of these links to access a printer-friendly version of the form. Please bring your completed forms with you for your first visit. Thank you.

Patient Registration Form
Financial and Insurance Information
Statement of Privacy Practices

Chief Complaint Form I
Chief Complaint Form II
Acknowledgement Of Privacy Practice Statement
Patient Survey


NON DISCRIMINATION NOTICE

CWPS complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. CWPS does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. 

LANGUAGE ACCESS SERVICES

CLICK HERE for a list of contacts for language assistance services free of charge.