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New Patients

Request your appointment, download forms and procedure instructions

New patients are asked to complete several important questionnaire forms. This information relates to basic family and financial information. You need tocomplete a medical history form and the receptionist will photocopy your insurance cards. HIPAA privacy forms will also be completed, per new federal law. This information is required to assure you will receive the best medical care.

We have made our new patient forms available for download as PDF’s. The downloads allow you to easily complete your new patient forms at home before visiting our office. You can either type your information directly within the forms and print, or you can  print first and hand-write your answers, and then sign your documents.  By bringing in your completed forms with you will save time and help expedite your check in process and your first visit.

FOR YOUR CONVENIENCE YOU CAN SEND YOUR COMPLETED FORMS DIGITALLY:

Scan the completed forms and send via email to: support@theperegrineinstitute.com

You may also fax your completed forms in to us at: 813-873-7776

 

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