Our physicians and staff will be happy to assist you with the completion of various school and sports forms, etc. Please call our office at (954) 423-2300 or (954) 384-8885 BEFORE completing the forms below.
On our website you will see both the parent’s and the doctor’s portion of the form. Please complete only your portion by following the instructions provided below. Once you have submitted your completed form we will complete the doctor's portion of the form.
Payment Options
There is a fee associated with the completion of all forms. We accept cash, checks, Visa, MasterCard, American Express and Discover Card as payment. Call us today at (954) 423-2300 or (954) 384-8885 and our staff will be happy to assist you.
Authorization for Medication/Treatment RX/OTC Medication Form
INSTRUCTIONS: Click the link below to print your form. Complete and sign Part 1 ONLY. Our office will complete Part 2 after we receive your completed portion of the form. E-mail the form to [email protected] or fax to
(954) 424-4200.
Immunization Record DH680
Please call our office at (954) 423-2300 or (954) 384-8885 for assistance. The Immunization Record DH680 does not require any portion to be completed by the parent or legal guardian. Our office will complete the form for your child.
State of Florida School Entry Health Exam Form 3040
INSTRUCTIONS: Click the link below to print your form. Complete Part 1 ONLY - ALL information in the top box, all 8 questions, signature of parent or guardian, and date. Our office will complete all information below your signature on page one, and all of page two after we receive your completed portion of the form. E-mail the form to [email protected] or fax to (954) 424-4200.
Florida High School Athletic Association Preparticipation Physical Exam Form EL2 FHSAA
INSTRUCTIONS: Click the link below to print your form. Complete Page 1 - ALL information in Part 1, and ALL questions in Part 2 - #1 through #46, WITH THE EXCEPTION OF #41 WHICH WILL BE COMPLETED BY OUR OFFICE. The student AND the parent/guardian must sign and date the form. Our office will complete pages 2 and 3, once we receive your completed portion of the form. E-mail the form to [email protected] or fax to (954) 424-4200.
College Forms
Since each college has their own forms, please visit the college website and search for the form(s) requested. You will need to print the form, and call our office at (954) 423-2300 or (954) 384-8885 for further instruction.
All Other Forms
If your child's form is not listed above, please call the office at (954) 423-2300 or (954) 384-8885. The staff will be happy to assist you.