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Download, print, and bring your completed new patient packet to your first visit.
New patients complete a registration packet covering contact and insurance details, the reason for your visit, your medical history, our financial policy, and a privacy notice acknowledgment. Finishing it before you arrive means less time at the front desk and more time with Dr. Mike.
Fill out the packet on your phone, tablet, or computer. One short section at a time, with a progress bar so you always know where you are.
Download the blank packet, fill it in by hand, and bring the completed pages to your appointment. Bring your insurance card and a photo ID as well.
Email is not a secure way to send health information, and we cannot accept completed packets by email or text message. Bring the printed pages with you, or call the office at 561-670-2010 if you need another option.
Photo ID, your insurance card, a referral or authorization if your plan requires one, a list of current medications with dosages, and any imaging reports or discs related to your problem.
Call 561-670-2010, Monday through Friday, 8:30am–5pm. Do not use these forms for urgent medical problems. In an emergency, call 911.