New Patients
 


Foot & Ankle Institute
Dr. Jason Dickerson
(801) 265-0600

Salt Lake Office
5872 S. 900 E. Suite 150
Salt Lake City, Utah 84121


Draper Office
11800 S. State Street Suite 350
Draper, Utah 84020
(Lone Peak Medical Campus)

All Major Insurances Accepted


Fellow, American College of Foot & Ankle Surgeons

  We appreciate you visiting our website, if you are a new patient to the Foot & Ankle Institute we want to make sure you feel comfortable and get answers to any questions you may have. Our office staff is very friendly and courteous. They will take the time to answer any questions and explain everything during your appointment.

For your convenience, you may download the applicable New Patient Registration & Medical History forms below and bring them to your first appointment to save time when you get here.

New Patient Registration Form

New Patient Registration Form / Minors

Medical History Form
In order to view or print these forms you will need Adobe Acrobat Reader installed.
Click Here to Download It

If you haven't already scheduled your appointment please Click Here to visit our Appointment Request page or you can call (801) 265-0600 Mon-Fri 8am-5pm to schedule an appointment.


 

   

 

 

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