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Patient Registration Forms & Privacy Notices

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

Registration Forms

Patient Registration Form

Patient Consent Form

Authorization for Release of Protected Health Information(PHI)

Autorización para el suministro de información

Financial Policy

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

These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here:

Get Acrobat Reader (this link opens a new browser window).

State of Florida - Patient's Rights

Healthcare Advanced Directives

Every competent adult has the right to make decisions concerning his or her own health, including the right to choose or refuse medical treatment. Please follow the below links to understand your rights.

Health Care Advance Directive - Patient's Right to Decide (PDF format)

About Health Care Advance Directives

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