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Lake Mary / Orange City (407) 391-3344


New Patient Forms


It may take too long to receive these forms by mail. You may print these forms and bring them with you during your appointment.

Fillable forms


 If you would like bilingual forms, click here


During the first visit, we make sure to obtain important background information, like your medical history, and give you time to get to know your doctor.  We accept most insurances.

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

  • Patient's insurance card
  • List of current prescriptions and/or over-the-counter medication, including dose and frequency
  • Information about patient's medical and surgical history
  • Recent test results, x-rays, or relevant records


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Insurance and Payment Information

You are responsible for co-payments or charges that are not covered by your insurance. If you have questions regarding billing or which insurance plans we accept, please call (407) 955-4511. Questions regarding insurance coverage and benefits should be directed to your employer or insurance company.

We also accept CareCredit.

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