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Home Dr Jon T Middelton Dr. Steven Richman Dr. Tom Dang Office Locations Office Staff Forms Appointments Services Patient Education Insurance & Payments Billing Links City of Toccoa City of Winder City of Commerce City of Cleveland City of Hartwell Employment Privacy Practices

 

 

 

 

Patient Forms

New Patient Consent Form

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Please download/print all the above forms and bring to your appointment 

 

 

 

 

Disabled Person's Parking Affidavit (form MV-9D)

 Form MV-9D

 

Other Forms

Record Release Form

X-Ray Release Form

 

 

All these forms require Adobe Acrobat Reader

 

The Family Foot Care Center

 679 Hospital Road  Commerce GA 30529 (706) 335-4884

2109 Hwy 129 S Cleveland GA 30528 (706) 865-0666

711 Rose Lane Toccoa GA 30577 (706) 886-9441

153 North Broad Street Winder GA 30680 (770) 867-1770

1087 East Franklin St. Suite G Hartwell GA 30643 (706) 376-9973

EMAIL:  familyfootcarega@yahoo.com