Your First Appointment | Patient Forms
Please arrive early so that we can complete your initial paperwork. Also, please bring the following if you have on file:
- 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
- Completed Patient Information form
Please print and fill out the Patient Information form to bring to your first appointment.
Insurance and Payment Information
Upper Bucks Foot & Ankle Medical Center is a provider for Medicare and most major insurance plans, and provides insurance billing. 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 contact us. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.
Fill out the form below if you are interested in Dr. Sedicum’s services and one of our team members will get back to you as soon as possible![/row]