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Call Us @ 352-732-5590
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NEW PATIENT FORMS

Welcome to our practice! To make you first visit easier and to save you time, please fill out the new patient intake forms before you come. Just click on the link below, fill it out completely and send it back to us. We will receive the form. Just make sure to call to schedule you first appointment. Also if you have any of the following, please bring them with you:

  1. Previous Medical Records
  2. Previous X-rays or Scans
  3. Insurance Card and other pertinent informatioon

If you visit is to follow-up on an automobile accident, also bring:

  1. Claim Number
  2. Insurance Company Information
  3. Accident Report
  4. Adjuster's name and phone number
  5. Contact information for your attorney if you have one.
  6. Any Emergency Room records from the accident that you may have.

Just click on the link below, fill out the form and we'll see you soon to begin your treatment!

 https://www.mychirotouch.com/patientintake/?clientid=OIM0001

 
 
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