New Patient Documents

We have made it easy for you to get started with your new patient paperwork. Select your insurance provider from one of the options below, download and complete the forms, and bring them with you on the day of your appointment.

If you do not see your insurance provider below or you have questions regarding your insurance, please send us a message or give us a call at 407-935-9012

Remember to bring all relevant paperwork and information with you on your next visit.

Bring these items with you:

  • Valid Drivers License
  • All Insurance Information
  • List of Medications
  • Immunization Records
  • Medical History
  • Guarantor Information (If Required)

Step 1: Select your Insurance Option Below.

If you are pregnant and on Medicaid, please download and complete these forms. We only accept pregnancy Medicaid at this time.

If your child is under 18 and your insurance for them is Staywell, please download these forms.

If your child is under 18 and you have Healthease for your insurance provider, please download these forms.

If you have a private insurance provider, please download and complete these forms. If you have Medicaid, Staywell, and Healthease, do not use these forms.

If you are self pay, please download and complete these forms. If you have Medicaid, Staywell, and Healthease, do not use these forms.