1121 NW 64th Terrace, Suite B, Gainesville, FL 32605    Phone: (352) 331-3583    Fax: (352) 331-3669
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New Patient Forms

If you are a new patient, please download and complete the forms below and bring them with you when you come for your appointment.

Patient Registration Form

Medical Information Release Authorization

Patient History and Symptoms

Patient Consent Form

Patient Information Designation

Financial Policy

Patient Discharge Instructions

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Notice of Privacy Practices

Aviso Sobre Las Practicas De Privacidad

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Privacy Policy