Are You a New Patient?

New Patient Forms

Please fill out each form below, they will be sent to our office automatically. If you have any questions, please call us at (321) 972-3960, or email us at office@felicecenter.com.

• Patient Intake form
• Case History form
• FCPR Agreement form
• FCPR HIPAA form

If you have difficulty or have any questions about the information in these forms, please contact us.