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New Patient Form 

Our goal at Family Foot and Ankle Specialists is to make your visit to our office as easy as possible. 

Because doctor office visit requires extensive but necessary paperwork to be completed. For your convenience, we are providing you an option to complete the new patient form online directly from our website.  

Once you complete this form, our front office staff will receive your form and create a file for your visit.

If you are not comfortable completing this online form, please click the button below to download a PDF copy of the form. Complete your form and bring it with you to your scheduled appointment.



Family Foot and Ankle Specialists, info@familyfootanklespecialists.com, Mon - Fri  8:30 am - 4:30 pm

Wyandotte Office

1628 Ford Avenue
Wyandotte, MI 48192
(734) 284-1333 Tel
(734) 284-1311 Fax
Office Hours
Mon - Fri: 8:30 AM - 4:30 PM

Southfield Office

24566 Southfield Rd.,
Southfield, MI 48075
(248) 423-4220  Tel
(248) 423-4221
 
Fax

Office Hours
Mon - Fri: 8:30 AM - 4:30 PM

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Dealing with any of these conditions ?

family foot and ankle specialists podiatric clinics conditions we treat

You don’t have to suffer the pain in silence. Come to one of our clinics for a medical consultation.

Having Foot and Ankle pain?

Consult With Drs. Khalil and Usen

Complete the form on the right for a complimentary consultation with Dr. Khalil, Dr. Usen, or any of our other Foot and Ankle surgeons.