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Book an Appointment

New Patient Pre-Registration

Important: This is for new and prospective patients to enroll in our practice. Please do not fill the pre-registration if you are already a patient in our practice.

Personal Details

Last Name

First Name

Middle Initial

Date of Birth (mm/dd/yyyy)

Marital Status

Gender

Race

Ethnicity

Language

Translator Required?

Address 1

Address 2

City

State

Zip

Home Phone

Cell Phone

Email

Insurance

Insurance Provider

Member ID #

Group #

Primary Card Holder

Pharmacy

Primary Pharmacy

Pharmacy Phone Number

Pre-registration Complete

Success! Your pre-registration is complete.

Here are your next steps:

On the next screen, you will be asked to select a clinician. When you do so, a new tab will open.
This new will take you to Healow's Booking screen. On the prompt that asks, "Have you been seen at this location before?", please select YES.
You will then be allowed to select a date and time for your upcoming appointment.

Select a Clinician

Please select a provider below to set up an appointment.

Remember to select YES at the prompt, "Have you been seen at this location before?" (Show me how)

Note: Selecting a clinician will open a new browser tab.

Success

Thank you for booking an appointment.
A welcome email will be sent to you during regular business hours.

For more information about becoming a new patient, please visit the "Getting Started" page

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Established Patients

(Healow App Required)

Select Insurance

Telehealth

Please select your insurance provider from the list below:
You can use Telehealth Services Only when Residing in the state of Florida Per current state laws.

My Insurance Provider is not listed

Select Reason for Visit

Please select your reason for booking a Telehealth Visit from the following options. If your reason is not listed below, please book a regular appointment instead.

Follow-up visits

Urgent Needs

My reason is not listed.

Select Reason for Visit

Please notate in your Healow booking that you wish to self-pay for telemedicine when making this request.

Self-pay telemedicine visits are sixty ($60) dollars flat rate. If you have insurance, it will not be used for this visit option. You will be advised to complete payment prior to scheduling. Our team will be contacting you for payment details ahead of your call (credit or debit card). This visit will be focused to your specific concern. Not showing up for these visit types, are same as our regular office policies. For more information please visit www.swofm.com/billing-information.

Below are some example visit types:

Follow-up visits

Urgent Needs

My reason is not listed.

Select a Clinician

(Telehealth Visit)

Important: Under “Reason for Visit”, please select “Telehealth” in the subject line to ensure that your appointment is booked as a Telehealth appointment.

Note: Selecting a clinician will open a new browser tab.

Telehealth - Success

You have successfully booked an appointment. Please refer to the video for a tutorial on how to access Telehealth from the Healow app.

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Select a Clinician

(Regular Booking)

Note: Selecting a clinician will open a new browser tab.

If you are booking with COVID virus concerns, please notate and/or otherwise call our office to be notified on Florida Department of Health and CDC protocol for this. Do not immediately walk into office. We now offer telemedicine via insurance or self pay to aid in triaging these scenarios.

Success!

You have successfully booked an appointment.

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