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770-667-4410


Patient Forms


New Patient

Please download and complete the New Patient Registration Forms and bring them with you to your first appointment along with your medical insurance card and photo ID. If you are unable or need assistance, we ask that you please arrive at our office 30 minutes prior to your scheduled appointment time.


New Patient Forms

Insurance

We accept most major health insurance plans, however it is your responsibility to contact your insurance carrier to verify coverage and benefits. Patients may be held financially responsible for payment of services should the insurance company deny responsibility. Be sure to bring your insurance card with you every time you visit Alpharetta Foot and Ankle Specialists. Notify the front desk whenever your insurance coverage changes so that the medical staff can accurately maintain your important medical records.


Pay Bill Online

Important Information

  • Patients can create an account or go directly to Pay Now
  • Please be ready to enter your Date of Birth in MMDDYY format and the account number as it appears on the statement with the 3 digit database at the end.
  • Example: Statement shows account 111111-XYZ (XYZ = Centricity Database). Enter as 111111XYZ on-line.
  • Continue to follow the on-line prompts to enter credit card information and to have receipt e-mailed.
  • For any questions, please have patients call the Galen Patient Services team at (678) 223-7932 or e-mail NSHPatientConcerns@galenadvisors.com
Click Here to Pay Your Bill Online

Please note this is not for processing any time of service money that is posted under an NCPY charge, please continue to use your current office processes for those funds.



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Dr. Harley’s Guide for Foot Care