New Patient Registration Form

     For your convenience, new patient registration forms may now be downloaded from this page. 

 

     Please complete the form to the best of your knowledge, and bring any supplementary but vital information (list of current medication, allergy list,  most current laboratory test results, diagnostic test results, etc.) with you on the day of your initial visit.  This ensures that all or most  of your medical information relevant to the purpose of your visit is supplied to the doctor, providing the doctor a more comprehensive overview or your current medical situation and  therefore making your initial visit more satisfying.

 

     Also, please remember to bring your insurance card and valid ID picture card on the day of your visit.

NPR_2017.pdf
Adobe Acrobat document [98.6 KB]

APPOINTMENT REQUEST FORM

For faster scheduling, please fill up the form below:

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Appointment Request Form

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Welcome to our new PATIENT PORTAL! To schedule an appointment, view and print electronic statements and request for medical records, please click the link below:

1905 W. Busch Blvd. 

Tampa, FL 33612

 

Phone: 813.365.3525

Fax: 813.365.3515

 

Clinic Hours:  

Tues/Thurs/Fri 

9:00 AM - 4:00 PM

Wed 2:00 PM - 7:00 PM

 

The Clinic is open on Mondays from  9am-4pm for administrative purposes only.

Get tested for allergies! ALLERVISION 69-Antigen Allergy Panel is NOW AVAILABLE! Get tested for allergies! ALLERVISION 69-Antigen Allergy Panel is NOW AVAILABLE!
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