New Patient Details

New to AMA Podiatry Introducing our new online patient forms. You can either fill out you details before your visit us or if you are a current patient and wish to update your details (if you have changed your phone number, health funds or your home address. Please complete and submit the form below.

    Do you have Private Health cover? (either private or ancillary)  

    Are you an EPC Patient enhanced primary care  

    Are you a DVA Patient dept veterans affairs  

    Would you like more information on .. Stretches ?   

    Running and your feet ?   

    Would you like to discuss this further with your podiatrist?   

    Past Medical History

    Have you ever experienced any of the following conditions?
    StrokeDiabetes(1or2)HypertensionFibromyalgiaHypotensionHepatitisMigraineOsteoarthritisHigh cholesterolRheumatoid arthritisDeep vain thrombosis

    Have you ever had EMS (shock wave therapy)?

    Used to treat Heel pain, Arch pain, Plantar fasciitis, Heel spur syndrome Plantar tears, Tibialis anterior, Posterior enthesopathy, Tendo Achilles.

    Would you like more information from your podiatrist?   

    Please select any of the following which describes your current symptoms ?
    Bunion( lump behind big toe)Bunionette (bunion behind little toe)Crooked toes or toe painForefoot pain/or swellingHeel pain or arch painMidfoot arthritis (lump or pain on top of foot)Joint pain and/or stiffnessCorns, callus, hard skinSkin lesions, wart, tumour, spot, blisterNerve pain( dull feeling, shooting pain, pins and needles, tingling)Ingrown toenailThick toenailsShin painLeg painKnee joint painHip joint painLower back painCold feetNight cramps of the feet or legs