Patient Forms

What You Need for an Appointment

Patients who fill out their patient forms, prior to their initial visit are more at ease during their appointment. It also saves you valuable time while you’re in our office. 

To fill out your new patient forms, click on the link below, print the form, and fill out as many fields as possible. Bring the forms with you to your first visit. Please take your time when filling out the forms and provide as much information as you can about your complete health history.

Ocala

HIPAA Form

Assignment of Benefits

Authorization for Release of Medical Information

Patient History

Request for Consultation

Patient Financial Policy

Patient Assistance Form

User Electronic Mail Authorization Form

Agreement for Controlled Substances/Prescriptions

COVID-19 Patient Medical Exemption Letter - OCALA

Panama City

HIPAA Form

Assignment of Benefits

Authorization for Release of Medical Information

Patient History

Request for Consultation

Patient Financial Policy

Patient Assistance Form

Agreement for Controlled Substances/Prescriptions

COVID-19 Patient Medical Exemption Letter - PANAMA CITY