New Patient Form
Complete the following if you have a Secondary Insurance
Answer the following section if your are not the policy holder of your health insurance
Please note that, in most instances, we will need your prior medical records before your visit. Please have your doctor's office send records or bring the records to our office prior to your visit.
We also encourage you to read the pdf version of the New Patient Paperwork, which includes New Smyrna Wellness Center's Policy and Procedures.