New Patient Forms

In a rush ! Make your visit faster by downloading and completing the required registration forms at home !

Patients visiting for an Urgent Care visit or Workers Compensation Injury must complete the NEW PATIENT REGISTRATION FORM: 

Patient Registration Form

Please complete as much of the form as possible ! We will need all the information on the form to complete your registration. Doing this at home will save you 10 minutes of paperwork in the waiting room !
If you have any questions when you arrive please let the staff at the front desk know so they can assist you to complete the form.

Patients visiting for a medical evaluation after being involved in a motor vehicle accident, related to the visit must also complete the following two forms, in addition to the form above:

1. Updated MVA form

The above form gives us the information we will need to allow us to file a claim with your auto insurance carrier and will be needed prior to being seen.

2. Updated MVA PIP policy

This form explains your PIP (personal injury protection) benefits and must be signed and returned to the front desk prior to being seen.

 

FLORIDA KIDS :

For your convenience these are the standard State of Florida forms required for:
1. Florida High School Athletic Association Preparticipation Physical Examination

SPORTS PHYSICALS
Sports Physical

(note some schools provide an extended form and may not except this one.)
2. Florida School Entry Health Exam required of any child starting school in Florida:

NEW STUDENT IN FLORIDA PHYSICALS
School Physical

WE hope these forms will help you expedite your visit , allowing you to complete the from in the comfort of your home and minimizing your wait time prior to being seen.

back to top

Contact Us Today!

Locate Our Offices