Forms

Below is a list of our necessary forms. To expedite your initial appointment, please print out, carefully read, complete and sign the forms. If you have any questions, please contact us immediately at (352) 243-5673.

Download the latest version of Adobe Reader HERE

To download a form, right-click and choose “save link as”.

New Patient Forms

Patient Information Form

Weight loss Consumer Bill of Rights

Cautionary Statement Concerning Use of Prescription Appetite Suppressants

Patient Acknowledgement of Cautionary Statement

Hippa Acknowledgement (Download, Print, and Sign the Acknowledge form HERE and bring with you to the office.)

Health History

Notice of Privacy Practices

Daily Forms

Daily Log