Name of Practice Download and fill out patient forms

Hospital Affiliation

AFFORDABLE CARE and YOU

You may qualify for low or no cost Preventive Care Services.

Annual Wellness Visit - Medicare Annual Wellness Visit - Non-Medicare


For more information or to schedule an appointment by phone, contact us at: (615) 377-4999 or book an appointment online...

21097 NE 27th Ct #350
Aventura, FL 33180

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Patient Registration Forms & Privacy Notices


If you are a new patient, please fill out the forms below and bring them with you when you come for your appointment.

Registration Forms

Patient Registration Forms - Adults

Patient Registration Forms - Minors

Medical Records Release

Family HIPAA Form

Financial Policy

Privacy Notices

This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Notice of Privacy Practices

Aviso Sobre Las Practicas De Privacidad

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