Forms for New Patients
Dr. Gerard F. Rainer, D.P.M.  

Online Form for New and Returning Patients

If you are a new patient to Foothills Foot Care Center, we
ask that you click on the attached secured link below and
fill out our new patient forms. This form is secure and
will require an
authorization code that you can obtain
through calling us at (864) 288-0048.

Filling out this form before your appointment will:

1. Help us analyze your medical needs before you arrive.
2. Saves you time filling out your forms in the office so
you can get in and out of your appointment faster!


Please call our office at (864) 288-0048
BEFORE clicking on the link. You will need an
authorization code to directly access your medical record.

Click here to access our secure online form:  
Patient Intake Form

After filling out your form please bring your Insurance Card and a picture ID for identification
purposes.

We can’t wait to see you!