Atlantic Health Medical Associates

has provided all your new

patient registration forms.

In order to make the new patient registration process as quick and easy as possible, we have posted all of the forms we require you to fill out upon arriving. Please click on the various links below and print the forms. Fill in all requested information and bring the forms with you on the day of your appointment. If you have any difficulties with completing the forms, please call (305) 931-7424.

 

These forms are in pdf format. If you are unable to view you will need to download the necessary plug-in.

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NMB:  North Miami Beach Office                                                           CS: Coral Springs Office

English Forms (All Offices)                                                                     Spanish Forms (All Offices)

 

New Patient Registration Forms (English)
Privacy Policy (NMB)

Privacy Policy(CS)

Authorization for Release of Medical Records (NMB)

Authorization for Release of Medical Records (CS)

Initial Clinical History and Physical Form
Medication Log

New Patient Registration Forms Espanol 
Privacy Policy Espanol Espanol

Authorization of Medical Records Espanol

Initial Clinical History and Physical Form Espanol