Patient Information

Patient Forms

Please print, complete documents 1 & 2 and have available for Dr. Wichman on the day of appointment:

If you have any questions, you can ask them when Dr. Wichman arrives for the visit.

Authorization for Release of Information* – only needed if you request transfer of records.

Notice of Privacy Practice optional

Please note: the forms are in PDF format. If you cannot read the PDF, please download the free Adobe Acrobat Reader from the Adobe website.


Please note: Dr. Kenneth Wichman of Manchester Podiatry Center, P.C. is available for house calls by appointment.

Please call 1-888-804-7180.