Make a Confident Referral to Balance Foot & Ankle Specialists

We welcome referrals from physicians, physical therapists, chiropractors, and other healthcare providers who trust us to deliver exceptional foot and ankle care. Our referral process is quick, seamless, and designed to ensure your patients receive the highest standard of podiatric treatment.

Patient Information

Name *

First

Last

Date of Birth

Gender (optional)

Phone *

Email *

Preferred Location

Please select the clinic location most convenient for you.

Insurance Card

Click or drag a file to this area to upload.

If you have a copy of your insurance card, please upload in PDF or JPG format (10 mb maximum)

Is there anything you would like to tell us? *

Referring Provider Information

Referring Provider Name *

First

Last

Provider Phone Number:

Provider Email Address:

Fax Number:

Practice Clinic Name:

Address

Address Line 1

City

State

Zip Code

Acceptance *

I understand and agree that any information submitted will be forwarded to our office by email and not via a secure messaging system. This form should not be used to transmit private health information, and we disclaim all warranties with respect to the privacy and confidentiality of any information submitted through this form.

Refer a Patient Online

Toenail problems.
Dermatology problems.
Foot problems.
Heel problems.
Ankle problems.
Diabetes.
Wound Care.

Just let us know how URGENTLY & WHEN you need your appointment. We will get your patient scheduled as soon as possible and also let you know!

If you are a doctor’s office or physician, please feel free to refer a patient to us.

We will make sure to get back to them during the same business day if possible.

Just let us know how urgent it is, and we will get back to you as soon as possible!

At Balance Foot & Ankle Specialists, we understand the value of collaborative care. When you refer a patient to us, you can rest assured they will be treated with respect, compassion, and expertise. From heel pain and bunions to complex biomechanical issues, our team delivers accurate diagnoses and evidence-based treatment plans tailored to each individual.

We make the referral process as smooth as possible for both providers and patients. Simply complete our secure online referral form or contact our office directly. Once the referral is received, our team will promptly coordinate care and provide feedback so you can stay informed every step of the way. Together, we can ensure better outcomes and healthier steps forward.

Make a Confident Referral to Balance Foot & Ankle Specialists

Patient Information

Referring Provider Information

Refer a Patient Online

Our Podiatry Services Locations in Michigan

Balance Foot & Ankle, Howell, MI

Balance Foot & Ankle, Bloomfield, MI

Our Company

Our Practice

Foot & Ankle Health Hub