Patient Forms and Payment Portal for Galbraith Podiatry Group
New Patients Forms & Information
First Visit Information
Please bring the completed form above, as well as your insurance cards with you to the appointment. Failure to bring your insurance card(s) to your appointment will result in you paying cash for the visit at the time of service or you may reschedule your appointment.
Be prepared to pay your FULL amount of co-pay and any owed balances.
Services will be turned away and/or reappointed until the co-pay is able to be settled in the full amount.
If you are uninsured and wish to be seen, be prepared to pay $100.00 at the time of service. The balance will be billed to you.
If you are on Medicare and Diabetic, please make sure that you have the date of the most recent blood sugar or A1-C done in your physician’s office. Must contain the month, day, year, and must match your physicians’ records, or Medicare will refuse payment.
If you are having heel pain or have been diagnosed with plantar fasciitis, please bring a pair of tennis shoes or good, basic lace-up shoes.
There is parking on the east side of the building and an entry from the parking lot.
Schedule an Appointment
To determine the cause of the pain in your feet, heels, arches, or ankles, call Galbraith Sanchez Podiatry Group in Wichita, KS to schedule an appointment. We will do everything we can to figure out what is making you hurt and then devise the right kind of treatment for your needs. When you are ready to come to visit us, please download and fill out the New Patient Form linked below.