Contact Info: Alan A. MacGill, DPM, FACFAS, CWS denotes required fields * First Name Last Name Phone Email Message Message General Internet communication is inherently not secure. DO NOT send data considered confidential or private in nature on this form. (e.g., Social Security Numbers, Diagnosis Information, Credit Card Numbers, etc.) Send 61078C7FB978F90ECF86BF03CD6DEBD2