New Patient Intake Forms

We offer several of our intake forms in a downloadable PDF format for your convenience. So you can fill out ahead of time, making your first visit more efficient. Simply click on the relevant packet to download. Then print it out, fill in the information, and bring it in with you on your first visit.

If you need any more information on which forms to complete for your visit, please feel free to call our office at (850) 862-3141.

If Mailing or Dropping off New Patient Forms.

Note: June 2023 Address Change to 816 Pinedale Road, Fort Walton Beach, FL 32547

• Confidential Medical Questionnaire
• Consent For Treatment
• Financial Policy Insurance Information
• HIPPA Acknowledgement of Receipt
• HIPPA
• Life History