828-327-3029

​36 14th Avenue NE Hickory, NC 28601

Forms

New Patients

Dear New Patient,
​Thank you for choosing Carolina Podiatry Center, the office of Dr. William Johncock. Below, you will find an information sheet and financial authorization forms.
Please take the time to fill out ALL THREE of these forms prior to coming to the office. Failure to have these filled out in advance may delay your treatment. Pay close attention and fill out your medical history completely. Be sure to include all the medications you are currently taking. This is vital to your care and treatment. Please remember to bring these forms with you at the time of your appointment.
WE LOOK FORWARD TO CARING FOR YOU!
Sincerely,
Dr. William Johncock and the Carolina Podiatry Center Staff

Forms

The following forms are for new and existing patients who have not been seen in three years or more. Each are in Adobe Acrobat (PDF) format. If you do not have Acrobat Reader, click here to download and install the application from the Adobe website.

Sports Medicine Injuries

For Sports Medicine Related Injury Patients Only:​ The additional “Sports Medicine History Form” is for those of you who are being seen for injury related to athletic activity. Please fill this out completely prior to your appointment. We also ask for these patients to bring their athletic shoes as well as some athletic shorts in the event that Dr. Johncock needs to evaluate your gait.