EMR Patient Registration

New Patients:

In order to serve you better and faster we have provided our New Patient Information Form online. This option allows you to complete your new patient information online. After you enter all of your information, click on the 'Submit' button and your information will be sent to our office electronically! Click one of the links below to begin the process.

If you are a patient for:
Jason Armstrong, DPM, FACFAS
or
Jerry Miles, DPM, FACFAS

Please click the link below to register:

If you are a patient of one of the following:
Scott MacTavish, DPM, AACFAS
Turner Butts, DPM, AACFAS
Scott Margolis, DPM, FACFAS
Larry MacTavish, DPM, FACFAS
Michael Gordon, DPM, FACFAS

Please click the link below to register:

Printable Form

If you would like to instead print out and fax in the form or just bring it in already filled out, the link below will enable you to do that.

Click on the link below to access the New Patient Form. After you click the link, a browser window will open. After it opens, click on the 'PRINT' icon on your browser. After the form prints, fill it out and bring them into our office, for fax to the appropriate office. Completing the New Patient Information Form will save you time on your initial visit!
Office Location
Northwest Office
Northeast Office
Magnolia Office
Liberty Office
Fax Number
281-444-7789
281-444-7789
281-356-4765
281-356-4765
*You must have Acrobat Reader to the view the .PDF files. Download Acrobat Reader Here