New Patient Forms

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Clinic New Patient Forms

New Clinic Patient Private Pay/Commercial Insurance Forms

New Clinic Patient Medicaid Forms

Aquatics Inquiry Form

Clinic New Patient Forms- Spanish version

Spanish New Clinic Patient Private Pay/Commercial Insurance Forms

Spanish New Clinic Patient Medicaid Forms

Community- Schools & PPECs

We are currently accepting new patients at the following schools & Prescribed Pediatric Extended Care Facilities (PPECs):

Blossoming Minds- Boca Raton
Florence Fuller East/West- Boca Raton
Fuller Academy- Boca Raton
Volen Center- Boca Raton
Divine Savior Academy- Delray
Luciano Martinez/New Pines Child Development Center- Palm Springs
Project Brilliance- LW/PBG
Little Dude Ranch- West Palm Beach
Children’s University- PSL
Dalton Learning Center & Academy- PSL
Primrose School- PSL
QLH Kids PPEC- Lake Worth
Lovin Arms PPEC- Lake Worth
Superhero Kids PPEC- Boynton Beach
Caresquare PPEC- Delray
Smiley Faces PPEC- West Palm Beach

Community- New Patient Forms

If your child attends one of our community site locations, please complete Community New Patient Forms below:

New Community Patient Private Pay/Commercial Insurance Forms

New Community Patient Medicaid Forms

Spanish- New Community Patient Private Pay/Commercial Insurance Forms

Spanish- New Community Patient Medicaid Forms