Contact us:

Tel: (954) 538-8543




We will make it easy for patients to be able to complete patient forms beforehand. You can click the following links below, fill it up online or print it and fill it up:


Patient e-Forms (English)

Patient e-Forms (Spanish)


Patient Forms (English)

Patient Forms (Spanish)

After filling up the forms, you can do the following:

  • Print it and bring it to the office.
  • Print it then fax it to (954) 431-8153.
  • Send an email to

Fatal error: Uncaught exception 'wfWAFStorageFileException' with message 'Unable to verify temporary file contents for atomic writing.' in /home/mariomag/public_html/wp-content/plugins/wordfence/vendor/wordfence/wf-waf/src/lib/storage/file.php:47 Stack trace: #0 /home/mariomag/public_html/wp-content/plugins/wordfence/vendor/wordfence/wf-waf/src/lib/storage/file.php(651): wfWAFStorageFile::atomicFilePutContents('/home/mariomag/...', '<?php exit('Acc...') #1 [internal function]: wfWAFStorageFile->saveConfig('livewaf') #2 {main} thrown in /home/mariomag/public_html/wp-content/plugins/wordfence/vendor/wordfence/wf-waf/src/lib/storage/file.php on line 47