East Lake Outpatient Center
3890 Tampa Road, Suite 304
Palm Harbor, FL 34684
(Located at the intersection of McMullen Booth Road
and Tampa Road.  See Map.)

Phone: 727-789-9006  ●  Fax: 727-789-9122
 

New Horizons Obstetrics and Gynecology is pleased to provide you with the convenience of filling out your new patient paperwork ahead of time, saving time for you when you arrive at the office.  Please download and print the following forms so you can fill them out ahead of time and bring them with you to your first appointment.  We regret that we cannot have you email the forms, nor can we accept faxes of completed forms.

(These PDF files will open with Adobe Reader.  If you do not have Adobe Reader, you can download it for free.)

 

• Forms for ALL NEW PATIENTS (4 pages)

• Additional forms for NEW OB PATIENTS ONLY (5 pages)
  
  
   

(Also see informational forms for download on our FAQ page.)