Your health is our priority! We are trying to make the process of “registration” as simple as possible. You can initiate your registration by yourself ! Just “click” below to begin your registration:
Or you can call us, text us or email us:
BY PHONE: 321-549-2273
BY TEXT: 321-613-8042
BY E-MAIL: firstname.lastname@example.org
Please give us a call for details!
W A L K – I N S W E L C O M E !
You can begin your registration by accessing directly to your patient portal as well as by completing all the “enrollment forms” within your portal. If you opt to begin your registration by yourself once you are at your portal be sure you click at the “Online Forms” tab to proceed to the Enrollment Form section.
Also you can initiate the process of registration by completing first the Enrollment Forms without accessing to the patient portal.
To begin completing these enrollment forms CLICK or SCAN on one of the QR-CODES (English or Spanish) below.
Also you can download these forms and complete them manually. Ask our office assistant to give you access (passcode) to these pdf forms.
- If you complete the Enrollment Form online we will contact you to make your appointment. Please keep a copy of your digital created enrollment form when you finished.
- If you complete the Enrollment Form manually please give us a call to schedule your appointment.
Either way by doing this part of the registration at home will expedite the process to be seen on your first visit.
The day of your first visit
- Come to your visit! either you complete your registration at home or at our office and we will see you!
- We can create you access to the patient portal (optional) the day of your visit.
ENGLISH FORM SPANISH FORM