Patient Forms to Print
Click on an item in the list below to view or download a document. Information provided in some of the document is subject to change without notice. Please see office staff for information.
Adobe Acrobat Reader is required to view the following files.
- Patient Intake Health History
- Medical Record Release
- Practice Brochure
- Map and directions
- Shelter Applications for Special needs (HURRICANE)
from the Lake County Emergency Management - INSURANCE GLOSSARY
- Intake cover letter
- Registration Form and Financial Policy
- Patient Policy Letter updated May 2008
- Medical device and medication fraud
from the FDA - Privacy Practices
- Florida Patient's Bill of Rights Summery
- Understanding Your Medical Bills
from the American Academy of Family Physicians - Vaccine Information Statement HEPATITIS A
from the CDC - Vaccine Information Statement HEPATITIS B
from the CDC - Vaccine Information Statement Shingles
from the CDC - Vaccine Information Statement HPV
from the CDC - Vaccine Information Statement FLU
from the CDC - HIPPA Friends and Family Release
- Do I Need Any Vaccinations Today?
from the Immunization Action Coalition