*Please speak with the Long Term Care facility to complete the consent form at the home. All of our contracted LTC homes have a copy of the paper consent on the unit or at the main office.

*All rates and further information can be found on the Niagara Mobile Foot Care side of the website.

If yes selected please provide, the client's information below

All rates, procedures, late payment fees, etc can be found on the Niagara Mobile Foot Care side of the website.

Appointments that are not cancelled 24 hrs prior to your scheduled appointment will be subject to a cancellation fee of $20.00 (this includes same day cancellations, no shows, see full policy for description). This fee will be added to your next appointment.

We ask these questions to ensure you are placed with the appropriate foot care provider. *The foot care providers cannot diagnose and prescribe medications. All foot care providers work within their scope of practice and will offer recommendations and referrals if necessary.

The client(s) and household ( residence of individual needing foot care services) does not have a fever, new onset of cough, worsening chronic cough, shortness of breath, or difficulty breathing? The client(s) and or facility does not have one or more of the following symptoms: sore throat, runny nose/sneezing, nasal congestion, hoarse voice, difficulty swallowing, decrease or loss of sense of smell, chills, headaches, unexplained fatigue/malaise, diarrhea, abdominal pain, or nausea/vomiting? The client (s) or facility has not had close contact with anyone with acute respiratory Illness in the past 14 days? The client(s) and or facility has not been in close contact with anyone with acute respiratory illness in the past 14 days? If the client (s) or facility is over 65 years of age, are they experiencing any of the following: delirium, falls, acute functional decline, or worsening of chronic conditions?