New Patient Forms

 Welcome to the FSU Health Lifestyle Medicine Clinic!

You may wish to use us as your primary care provider or as a consultant for only one or more specific problems. We will gladly send information to your other health care providers at your request.

If you are a scheduled new patient, please complete the following forms prior to your appointment. If it is not possible to fill out ahead of your appointment, please arrive 15 minutes early to complete the paperwork.

[NEW PATIENT FORMS]

Completed new patient forms may be faxed to us at (949) 655-8526, emailed to clinicinfo@nursing.fsu.edu or dropped off at 1630 Riggins Road, Tallahassee, FL, 32308.

If you have chronic health problems, it will help us better serve you if you also complete the Medical Symptom Questionnaire and Nutrition and Lifestyle Journal along with any other appropriate information that seems appropriate for you and your symptoms.