Patient Registration Forms & Privacy Notices

To schedule an appointment at our facility, please call our office at (850) 878-2273 or toll free at (800) 797-5433 between 8:00am and 4:00pm. We will make every effort to schedule your appointment quickly, usually within 2 business days.

When you come to your first appointment, please bring a valid photo ID, current medical insurance cards and the medications you take. Please arrive 30 minutes prior to your scheduled appointment time. You may also complete our new patient registration forms prior to your first appointment. Simply print out the forms below, complete them and bring them with you to your first appointment. If you have done this, you need only arrive 10 minutes prior to your scheduled appointment time.

We look forward to seeing you at your appointment!

Registration Forms

If you are a new patient, please fill out the registration forms listed below in advance of your appointment to assist the staff in making sure that we have all the information necessary to provide you with quality care and treatment. Please bring the completed forms with you to your appointment.

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.