Patient Forms

Below are our Patient Information Forms in both English and Spanish that may be completed either online, prior to your walk-in visit or once you have arrived to the office.  All areas that apply must be entirely filled out with your electronic signature inscribed on the bottom of the form.

It is important to note that we will need photo identification for any service rendered and any other pertinent information (insurance cards, and any medical reports that apply to your visit, etc.) would also be helpful.

The third document, HIPAA, explains your rights and privacies as a patient. We ask that every patient read the HIPAA document entirely either before coming in for treatment, or while in the office.

 Patient Registration Form: English
 

 Patient Registration Form: Spanish

If you have any questions regarding the following documents, please feel free to contact our office at:

786-923-4000

Or email us at:

info@myfastcare.com