Please fill out the attached form, you can either fax, email or bring this with you to your visit. If you do not have the ability to print these you can fill this out when you arrive but please arrive early for your visit.
fax- 954-202-0243
email- pthompson@ftlaudsurgical.com.
Please remember to also bring a photo ID with you to the visit along with your Insurance cards. We no longer take cash in the office, if you have a copay for your visit we can except credit cards and checks.
THANK YOU!