Downloadable Forms
The following forms are available for you to download, open with Adobe Reader, complete, print out, and sign prior to your first visit to your office.
Adobe Reader is free and can be obtained here: 
Every new patient is required to fill out this new patient enrollment form before being treated. Instead of spending additional time in our office filling these forms out please feel free to open them here, fill them out on your computer, print them off, sign them, and then bring them in with you on your first visit.
Even if you fill out this form online you still must call us at: (954) 450-3550 to make an appointment. Make sure to bring in the form when you come in for your appointment.
New patients should bring the following to their first visit:
- Photo ID
- Medical Insurance Card
- A list of prescription and non-prescription medicines you are taking
Release of Medical Records Form
In order to properly treat our patients we require your prior medical records. Only you the patient, or the responsible party (e.g. if the patient is a child) can request these forms. Please fill out our release of medical records forms and submit them to your previous medical doctor. Once you have done this they are obligated by law to release your medical records to us.
If you are visiting the Physician because of an automobile accident you are required to fill out this form out, in addition to the new patient enrollment form if you are a new patient. Existing patients who are seeing us because of an accident for the first time (as opposed to seeing the Doctor for a normal check-up, illness, etc.) must also fill this form out. Save some time by filling it out on your computer and printing if off before your office visit.
Even if you fill out this form online you still must call us at: (954) 450-3550 to make an appointment. Make sure to bring in the form when you come in for your appointment.
Immigration and Naturalization Form
If you are coming in for immigration and naturalization physicals or shots please fill out Part 1 of this form.
Even if you fill out this form online you still must call us at: (954) 450-3550 to make an appointment. Make sure to bring in the form when you come in for your appointment.
Pre and Post Skin Peel Instructions and Waiver
If you are coming in for a skin renewal peel please read these instructions that describe what you need to do before your appointment.