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Be sure to carefully follow all the instructions below.

PATIENT INTAKE FORMS

  • Complete our online Patient Intake forms below. Sign and click the submit button.
  • Review the Consent forms, taking care to ensure the consent boxes are checked. Sign and click the submit button.

TIP: Disregard Part B. That section is just for minors.

PROOF OF CONDITION & DRIVERS LICENSE

Before you begin the forms, be prepared to upload a photo of your Florida drivers license and your Proof of Condition (medical records diagnosis). The Identity Documents Section is where you will upload the required documents.  If you need more information about acceptable Proof of Condition, return to the previous screen here.

TIP: The accepted formats to upload are: jpg, gif, png.

SCHEDULE YOUR APPOINTMENT

After your forms are submitted, schedule your appointment. Follow the below guidelines for choosing the correct appointment type. Click on the Chat Bot to receive your exclusive discount coupon code!

NEW PATIENTS | Select your preferred location. Don’t see a location in your city? Click on our customer service chatbot for the location to choose.

TRANSFER PATIENTS | Head on over to your page here: RECERTIFICATIONS

BEGIN PATIENT INTAKE PROCESS NOW - DON'T FORGET YOUR COUPON CODE

BE SURE TO FOLLOW ALL THE STEPS. REVIEW THEM AGAIN IF NECESSARY. ANY OMISSIONS OF INFORMATION, LICENSE UPLOAD, MEDICAL DIAGNOSIS UPLOAD, CONSENT FORM SUBMISSION OR SCHEDULING YOUR APPOINTMENT WILL CAUSE DELAYS.

Text Us for Help | 813.774.3474

CONTACT US

Chat Bot

Email: [email protected]

HOURS

Monday – Friday  9:00 to 5:00

By Appointment Only – No Walk-ins


HEADQUARTERS

2111 W Swann Avenue

Tampa, FL  33606

REVIEW US

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LOCATIONS

Tampa

Jacksonville

Orlando

Daytona Beach

Melbourne

Sarasota

Click the Chat Bot to connect to a live Operator for other locations.

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