Registration:

On your first visit, you will be required to complete several documents for our records.  These documents include a history and physical form, a registration form, a HIPAA acknowledgement, and medication list.  The information you provide is necessary for our staff to review past medical history, bill your insurance company, provide us with emergency contact information, schedule future appointments, update medication list, etc.  To help expedite this process we are providing copies of the forms in a downloadable format for you to download, print and complete thoroughly in the comfort of your home.  

History and Physical Form
Billing Information
Information Release Authorization
Medication List

 

217 Hillcrest St, Orlando, FL 32801 - 407.425.1566
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