DOWNLOADABLE FORMS
New Patient Forms
Visiting a new healthcare provider for the first time can be a little stressful. The last thing you want to worry about is filling out forms when you arrive. To make things more efficient, you may download (and print) our new patient packet that contains all of the necessary forms and information you need to fill out before your first (new patient) visit.
Once completed, you may send the forms back by dropping them off at our office or bring them with you on your first visit.
Please complete this form in advance of your scheduled first visit.
New Patient Check List
- Completed new patient packet
- All medical records from all your other providers (including hospital, specialists, facilities, etc.)
- Insurance cards
- Government-issued photo ID (i.e. State ID, Driver’s License)
Disclosure of Medical Records
To release or request for medical records, please complete and fill out all necessary information on our Authorization for Request/Release of Medical Records. This form must be completed at each request.
Once completed, you may send the forms back by dropping them off at our office or bring them with you on your visit.
Please allow 48 to 72 hours to complete your request. For immediate assistance, please contact our office at 352-633-8681.
PATIENT PORTAL
Patient portal and personal health records
Help patients play a more active role in their health.
The patient portal is a secure online access to patient’s personal health information. It requires a secure username and password.
To create or log in to your profile, please click the link below.
INSURANCE PARTICIPATION
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