Patient Registration Forms & Privacy Notices
Below are our forms that are available for you to print out and bring with you to your appointment.
- Authorization for Medical Records Release
- FHSAA - Preparticipation Physical Evaluation
- State of Florida - School Entry Health Exam
- HIPAA Acknowledgement Disclosure Consent
NFRMC New Hires
Patient Rights & Responsibilities
We respect our patients’ dignity and pride. This document will explain your patient rights and responsibilities. It is part of your patient registration and is an important part of your health care plan.
This privacy notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
- Notice of Privacy Practices (provided for you at your first visit)
- Aviso Sobre Las Practicas De Privacidad (proporcionada por usted en su primera visita)
These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here: