Patient Forms

New Patient Demographics

This is the form for NEW PATIENTS DEMOGRAPHICS. Please download, complete, and bring it with you to your first visit. 

 

Medical History Form

This is the form for NEW PATIENTS' MEDICAL HISTORY. Please download, complete, and bring it with you to your first visit. 

Patient Portal

We are pleased to provide patients with secure, 24/7 access to their health records through the Patient Portal. Patients can safely and easily:

  • Request prescription refills
  • Update insurance/demographic information
  • Review financial statements/make secure payments
  • View lab and test results
  • Access relevant health education materials  

Patient Portal Login

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We accept many insurance plans. For questions about insurance, please contact our office.

Aetna
AvMed
Blue Cross Blue Shield
Cigna
Humana
Medicare
Tricare
United Healthcare
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Advanced Urogynecology
2501 North Orange Avenue
Suite 210
Orlando, FL 32804