New Patient Forms

Share Button

control-427510_640For your convenience, Windermere Medical Center provides all registration forms below that need to be completed and submitted prior to scheduling an appointment with one of our providers.

Please email your completed Office Policies and Registration Packet to NewPatient@WindermereMedicalCenter.com, or fax to (407) 801-6355. In the subject line, please enter Your Name/New Patient Paperwork.

One of our dedicated Front Desk staff will contact you within 2 business days to schedule your appointment.

Office Policies

Our WMC Patient Policies have been updated for 2017. Click on the link to review, print, and complete our policies. This must be included with your registration packet.

Office Policies

Internal Medicine

Please click on the “WMC Registration Packet” to print and complete these forms.

WMC Registration Packet

Pediatrics

All registration documents, including the Office Policies, and your child’s vaccine records, must be sent to our New Patient email or fax number. Once we receive all completed forms, your child will be registered, and one of our dedicated Medical Assistants will contact you within 2 business days to schedule your child’s appointment.

WMC Peds Registration Packet

WMC Consent to Treat

Chiropractic

On the job injuries or every day back and neck pain can receive relief with the help of chiropractic care. Please complete the WMC Office Policies and Chiro Registration Packet, and email your completed forms to Chiro@WindermereMedicalCenter.com, or fax them to (407) 986-9679. In the subject line, please enter Your Name/New Chiro Patient Paperwork. Our dedicated Chiro Front Desk staff will contact you within 2 business days to schedule your appointment.

Motor Vehicle Accident/Personal Injury/Worker’s Compensation

Have you been injured in a work or automobile accident? Complete the WMC Office Policies and the applicable form(s) below. You may bring them with you to the Walk-In Clinic to be seen on the same day without an appointment.

WMC Registration Packet

Personal Injury-Motor Vehicle Accident Form

WMC Auto Accident Information

Worker’s Comp Form