Center for Gynecology & Pelvic Surgery

Call Today for an Appointment! (352) 253-4778
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New Patient Information

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New Patient Information

 

 Click on the links below to download any of our new patient forms and learn about new patients at our 
 practice.

Authorization For Use or Disclosure of Protected Health Information Form.pdf
Authorization For Use or Disclosure of Protected Health Information Form - Pg. 2pdf.pdf
Bladder Health Questionnaire Form.pdf
Bladder Medication Form.pdf
Communication Use and Disclosure Authorization Form.pdf
Consent for Evaluation or Treatment Form.pdf
Patient Information Form.pdf
Patient Summary Form.pdf
Written Acknowledgment of Receipt of FPMG Notice of Patient Privacy Practices Form.pdf








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Center for Gynecology & Pelvic Surgery is operated by Florida Physicians Medical Group.


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Center for Gynecology & Pelvic Surgery

3350 Waterman Way, Tavares, Florida 32778
Phone (352) 253-4778 Fax (352) 253-4779
McMurry