Please take the time to fill out this form before your first visit. The form can be filled out in one of three ways: 1. Fill out the form online and submit online, 2. Fill out the form online, submit online, and print a hard copy, and 3. Download and print the PDF, then fill it out and take it with you to the office.

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  • Read Our Patients Experiences

    Foot & Ankle Institute of New England
    4.9
    Based on 100 reviews
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    Vure Resendes
    Vure Resendes
    16:35 16 Jan 20
    I found the office to be professional, welcoming, and knowledgable!
    Bambi Watkins
    Bambi Watkins
    21:40 13 Nov 19
    The office staff and the Medical Assistant's are very pleasant ladies. My Dr Rogers is very friendly and very understanding to my needs I would not go to anyone else he's the best.
    Loretta Mcmahon
    Loretta Mcmahon
    01:54 22 Oct 19
    Dr gallucci and staff are friendly great bedside manor and eager to help with any of your feet/ankle problems highly recommended
    Michelle Whittaker
    Michelle Whittaker
    14:02 16 Sep 19
    My son was cared for by Dr. Roger's. Dr. Roger's cared for my son like he would care for his own children. I highly recommend Foot & Ankle Institute of New England.
    Annemarie Palaya
    Annemarie Palaya
    22:27 28 Jun 18
    Dr Rogers has been a miracle not only did he fix my right ankle that was missing a piece of bone for over 15 years, he also fixed my left one when I took a fall and hurt my left ankle and needed a reconsideration of my ligaments and tendons. He treated me as if I was a member of the family always answering all my questions honestly and didn’t give me any false hope. He was always open and honest with all my questions. I would recommend him to anyone who has problems with no answer on how to fix the foot. Also thank you to Krystal and Kristen for always being friendly and caring. Kristen thanks for the amazing cast jobs. It has been awesome to have someone who knows how to make a cast. All the staff has been amazing . Sorry if I miss anyone.
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