Download, print and bring your forms to your appointment:

Release of Medical Records

Use this form to request your records be faxed or mailed to another party, or yourself. To ensure our staff can process your request accurately, fill out the form completely. Please allow 48 hours to process.

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Patient Registration

This form provides patient demographic and insurance information.

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Medical History

Medical History Form must be completed in full and should be updated regularly (at least once a year).

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Insurance & Financial Policies

Outlines some of Florida Otolaryngology Group, P.A.'s insurance and billing polices.

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Privacy signature page

Privacy signature form identifies who you are allowing access to your medical records.

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Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information.

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