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Intake Form

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Niagara Mobile Foot Care is now booking appointments for foot care with limited availability. All foot care appointments are triaged based of urgency. If you do not wish to fill out the form, please call (905) 708-9817 

Online Intake Form
Niagara Mobile Foot Care's online intake form to help make an appointment easier for you. Following your completion of the form reception will contact you to set up the date and time of your appointment via email. The form is confidential and only shared within the foot care team.
New residential clients will be waitlisted at this time. Previous residential clients will be triaged based on their foot care needs.
We have contracts with some of the facilities throughout Niagara
If yes selected please provide, the client's information below
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 and no shows). This fee will be added to your next appointment.
Due to COVID-19 we have limited capacity per day for client appointments.
In other regions of Niagara, you can be connected with an independent foot care nurse that will self schedule your appointment (Rates Vary). Examples-Thorold, Niagara on the lake, Welland, Port Colborne/Welland Port, St. Davids, Niagara Falls, Stevensville/Ridgeway, Vineland, Grimsby, Wainfleet
We have contracts with some of the facilities throughout Niagara
All forms must be completed on every client. You can request a copy for your records