Forms Needed by New Patients:
If you have tailbone pain and would like to be seen by Dr. Foye, then you are in the right place!
Below is the PDF form that you will complete and send in.
Note that this is ONLY for people who are willing, able, and planning to come to see Dr. Foye in-person at his Tailbone Pain Center in New Jersey, United States. (Even though the initial visit might be Telemedicine, it is only for those who are planning to come for an in-person visit for medical evaluation and treatment.)
Download the form. It is a PDF. (After you click on it below, it will either pop up in a new tab on your internet browser, or it will be in your “Downloads” folder on your computer.)
Then you can fill out the form on your computer (it is a PDF where you can type in your information). Or you can Print it out and fill it out by pen. Whatever you prefer!
Complete the paperwork and then send it to Dr. Foye’s office. The first page of the form explains how to send it.
Then Dr. Foye’s office staff will call you to schedule your appointment.
We look forward to receiving this from you so that we can schedule your appointment. Thank you!

Adults only: New patients must be at least 18-years-old. Children with coccyx pain should see their pediatrician and a pediatric orthopedic doctor.

Here is the Form to Fill Out and Send to us…
(You need to Send this to us BEFORE you will be given an appointment to see Dr. Foye)

These forms are copyrighted and are not authorized for any other use.

“Optional” Forms are shown below

(The Forms shown below are NOT needed by most patients)

Document (Optional Form): Getting Xray copies from University Hospital (Optional Form): For patients who want a copy of x-rays done at University Hospital (on Dr. Foye’s campus)