Peter Smith, DPM, PC
Contact Us/ Registration Forms
Home | What do Podiatrists Treat? | Location | Contact Us/ Registration Forms | About the Doctor | Meet Our Staff | Insurance/billing

Please call our office to arrange an appointment.  Our Phone number is  (631)689-2300
 
If you would like to speed up your initial consultation time, please download these forms, and have them completed when you arrive.

Patient Registration Form

Medical History Form

HIPPA Acknowledgement

Insurance Authorization

Financial Policy and Patient Agreement

 
 
 
Questions or Comments?

Do you have any questions or comments about our services? Send them to us. We would love to know what you think.

Give us a call at: (631) 689-2300

Or fill out our short questionaire below.

You can e-mail Dr. Smith by clicking here

1. Have you been to the office already? If no, please proceed to question 12.
2. Were you seen in a timely manner?
3. Was the reception area neat, clean, and inviting
4. Was our staff friendly and helpful?
5. Were our treatment rooms neat and clean?
6. Did the Doctor address your primary complaint?
7. Did the Doctor explain your diagnosis clearly
8. Were you given treatment options, and were they explained clearly to you?
9. Were you satisfied with your experience at our office?
10, Was your insurance information processed properly?
11. Would you recommenr this practice to a family or friends?
12. Do you find this website helpful and informative?
13. Additional comments about our practice, or this website?
  

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Please call for appointments
(631)689-2300