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Welcome to Masri Medical.

We thank you for choosing us for your medical care needs and look forward to seeing you at your upcoming appointment.


Our goal is to provide you with the best coordinated care possible. To reach this goal, our professionals take a comprehensive, leading-edge approach to the assessment, treatment, and rehabilitation of each and every one of our patients.

 

In order to expedite the registration process, we kindly ask you to print out and complete all of the following forms. You can then either:

·         Bring them with you to your first appointment, or even better

·         Fax them ahead of your appointment to (407) 703-5920, or

·         Scan, complete and e-mail them to This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Patient Registration Form (4 pages, required)

 

Patient Expectations and Responsibilities (1 page, required)

 

Patient Financial Agreement (2 pages, required)

 

Patient Privacy Practices Information (This is a Read Only file)

 

Authorization to Release Medical Information Form (Use only if needed)

 

We accept VISA, Mastercard, Discover, Check or Cash.   

In addition, please bring your insurance card, co-payment and referral, if applicable.


Thank You.