Search Search ... New Patient Forms As a convenience to "you", our patient, Mid-Florida Primary Care is pleased to offer online new patient forms for you to print out and complete. Please have completed forms, identification card/drivers license, and all insurance cards with you at time of visit. Welcome to our Practice Medical Home Information FAQ Patient Information History and Physical Practice policies Financial Policy Advanced Directives HIPAA Acknowledgment Form HIPAA Privacy Notice Medical Record Release Authorization Form Complete Package To view the forms listed above, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com powered by BirdEye Main Menu Home New Patient Forms Services/Specialties Test Preparations Quality Improvement Activities Contact Us Urgent Care Log In Patient Portal Leesburg 401 North Blvd West Leesburg, FL 34748 352.728.4242 Mon - Fri 8AM - 5PM Summerfield 17809 109th Avenue Summerfield, FL 34491 352.307.4200 Mon - Fri 8:30AM - 5PM Walk-Ins Welcome Same Day Appointments powered by BirdEye Back to Top © 2021 MFPC

Search Search ... PROCEDURES PERFORMED IN OFFICE INDICATIONS FOR EACH TEST: 2D Echo Arrhythmia\A fib Chest Pain, Angina, Coronary Artery Disease CHF - Congestive Heart Failure Valve Disorder\Valve Replacement AAA (Abdominal Aortic Aneurysm) Abdominal Ultrasound Carotid Ultrasound Cryofreeze DEXA Bone Density EKG and Holter Monitor for evaluation of cardiovascular disease including Injections-joint and trigger point Skin Surgeries and Procedures Nerve Conduction PAD (Peripheral Arterial Doppler) Infusion/Injectable Therapy Pulmonary Function Test Radio frequency ablation\Electric Cautery for skin disorders Stress Test powered by BirdEye Main Menu Home New Patient Forms Services/Specialties Test Preparations Quality Improvement Activities Contact Us Urgent Care Log In Patient Portal Leesburg 401 North Blvd West Leesburg, FL 34748 352.728.4242 Mon - Fri 8AM - 5PM Summerfield 17809 109th Avenue Summerfield, FL 34491 352.307.4200 Mon - Fri 8:30AM - 5PM Walk-Ins Welcome Same Day Appointments powered by BirdEye Back to Top © 2021 MFPC

Search Search ... Test Preparations ECHO - CAROTID - PAD -VD -AAA 30 Minute Test (s) No preparation necessary ABD DEXA Scan PFT Upper Extremity Test Lower Extremity Test Stress Test powered by BirdEye Main Menu Home New Patient Forms Services/Specialties Test Preparations Quality Improvement Activities Contact Us Urgent Care Log In Patient Portal Leesburg 401 North Blvd West Leesburg, FL 34748 352.728.4242 Mon - Fri 8AM - 5PM Summerfield 17809 109th Avenue Summerfield, FL 34491 352.307.4200 Mon - Fri 8:30AM - 5PM Walk-Ins Welcome Same Day Appointments powered by BirdEye Back to Top © 2021 MFPC

Search Search ... Quality Improvement Activities Shares Information with Practice Staff Quality Performance Report QI 15 - Shares information with practice staff powered by BirdEye Main Menu Home New Patient Forms Services/Specialties Test Preparations Quality Improvement Activities Contact Us Urgent Care Log In Patient Portal powered by BirdEye Back to Top © 2021 MFPC