Florida Wellness & Rehab offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

• If you do not already have AdobeReader® installed on your computer, Click Here to download.
• Download the necessary form(s), print it out and fill in the required information.
• Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Intake Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Informed Consent Form - Required

This form enables Florida Wellness and Rehab to provide services to the patient.

HIPAA Information and Consent Form - Required

This form outlines your rights provided by the Health Insurance Portability and Accountability Act and addresses what Florida Wellness and Rehab can and cannot do with your information.