Complete our online Patient Intake forms by clicking any header or button.
Be sure to complete all fields marked with a star. Be sure to have your license and proof of condition ready to upload!
BEFORE YOU BEGIN THE PATIENT INTAKE FORMS | Be prepared to upload a photo of your Florida drivers license and your Proof of Condition (medical records diagnosis).
DO NOT SUBMIT A DOCUMENT THAT IS NOT READABLE OR TOO SMALL TO VIEW.
ACCEPTABLE FORMATS: jpg, gif, png
After your forms are submitted, a Schedule Appointment button will appear on the same page.
Need help? Text us at 813.774.3474