Forms & Documents
Save time at your visit by completing your forms ahead of time. Fill out your intake form online and it will be sent directly to our office, or download the PDF to fill out and bring to your appointment.
Complete your patient information, medical history, HIPAA acknowledgment, and assignment of benefits — all in one PDF. Fill it out digitally or print and complete by hand, then email to us or bring to your appointment.
Learn about our Medicare-covered diabetic shoe program, eligibility requirements, what to bring, and frequently asked questions about diabetic footwear.
Download Info SheetWhat to Expect
We want your first experience with Kinetic O&P to be smooth and comfortable. Here's what to expect.
Call us or use our contact form to schedule your initial evaluation. We'll confirm your insurance coverage.
Download and complete your patient forms ahead of time, or arrive 15 minutes early to fill them out.
Meet with your practitioner for a thorough evaluation. We'll discuss your needs, goals, and create a care plan.
Custom fabrication and fitting of your device, with follow-up visits to ensure the perfect fit and function.
Coverage
We work with most major insurance providers. Contact us to verify your specific coverage before your appointment.
Don't see your insurance? Call us at (815) 401-7260 — we'll verify your coverage for you.
Be Prepared
Having these items ready will help make your appointment as efficient as possible.
Hours & Location
(815) 401-7267
info@kineticop.com
Monday - Friday: 8:00 AM - 4:30 PM
Closed 12:00 - 1:00 PM (Lunch)
Saturday & Sunday: Closed
Download your forms, fill them out, and email them to us — or bring them to your first appointment.