4912 N. Armenia Avenue
Tampa, FL 33603
813-961-9393
Fax : 813-960-9020
Your Health Care Resource ~ Compassionate Care
Patient Forms
For our patient's convenience and to expedite visit wait time to our office, click the buttons below for our New Patient form packets and Yearly Follow up Packets available for your download and print and/or to complete the pdf forms on computer that are fillable. Please complete prior to arrival at our office. Email them back to our office after "saving". In addition, please make note if you are having telemedicine visits please sign and email the consent form to our office.
PLEASE NOTE: It is the PATIENT's responsibility to NOTIFY our Provider and/or Staff of any changes to your Insurance, Mailing Address, Contact Information, Marital Status! If we are not notified on Insurance changes and/or the above and billing your insurance does not process, you will be responsible for full payment of visit(s) that are un-billable to the insurance payor (there are deadlines). Please notify our office immediately so we may update our system. You may also update your information in the Patient Portal.
If you have not signed up on to your FOLLOW MY HEALTH PORTAL (a link is auto sent to your email provided on file) please do so as soon as possible. This is a requirement now for our practice. You will have access to your medical information to assist you better in coordination of care and/or visits and provide us real time updates to the aforementioned VITAL demographic information.
New! For your convenience the forms are in PDF FILLABLE on computer format. To sign the document use the 'drawing' tool at the top of pdf screen while form is open. To send the completed form in this digital format, Save the form (download) on your computer and reattach the file to the email sent to our office.
