Need to book a foot care appointment? 1 (905) 7089817
Welcome to Niagara School of Foot Care/ Niagara Mobile Foot Care

Welcome to Niagara School of Foot Care/ Niagara Mobile Foot Care

Book an Appointment

Intake Form

Home > Intake Form
 If you do not wish to fill out the form, please call (905) 708-9817 
Online Intake Form New Service
We are excited to offer you our new foot care services! Before you begin filling out the online intake form, please take a moment to read the information provided on our website. This will ensure you are fully aware of all costs, policies, and procedures associated with our service. Once you have completed the form, our foot care team will contact you via email to schedule the date and time of your appointment. Rest assured, the information you provide is confidential and will only be shared within our foot care team.
*Please note that we currently do not visit NHS hospitals, only Shaver Hospital.
If you selected LTC, retirement, or group home, kindly specify the name of the home. We have contracts with various facilities throughout Niagara, so it’s important to name the facility as we might already have an existing contract with them.
If you are unsure, please select the option for us to contact you. Further details and rates are available on the Niagara Mobile Foot Care section of our website.
Again, if you are unsure, please select the option for us to contact you. Detailed rates and information are also available on our website.
*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.
Please acknowledge that our foot care providers (PSW, RN, RPN) have completed training in therapeutic, non-invasive foot care and use only single-use or sterile equipment/supplies, following strict Public Health Guidelines. We do not offer pedicure services.
We also have a Cancellation/No Show Policy. Please always call and cancel your appointment if you are feeling unwell. Appointments not cancelled 24 hours prior to the scheduled time will incur a cancellation fee of $20.00, which will be added to your next appointment.
These questions help ensure you are placed with the appropriate foot care provider. Our foot care providers work within their scope of practice and will offer recommendations and referrals if necessary.
Lastly, please confirm that the individual completing the form has done the self-assessment for respiratory illness screener and that the household is clear. If not, please postpone care.