Information New Patient Forms

To expedite the check in process please have the following filled out:

Downloads:

This is an electronic form, you may fill it out on a computer; please remember to print and bring this with you when you arrive for your appointment.

New Patient Form (PDF, 1336 KB)

• Please show up 15 min prior to your appointment time.
• Sign in at the front desk.
• If you're not comfortable waiting in the waiting room, sign your name in, leave your number, and we will call you when it's your turn.

Information Record Requests

For Record Requests:

We are currently working on a records portal. In the mean time please email us at: records@bocaratonfamilyandpediatricclinic.com or via fax at: (+1) 561-477-2864

We will need the following data:

• Requesting type?: Patient, Lawyer, or Insurance Company
• If Lawyer or Insurance Company: Please provide the company name
• Patient First and Last name
• Patient Date of Birth
• Email
• Telephone Number
• Receiving Method?: Email, Fax or Portal
• If Company portal: please provide URL and username and password