Patient Forms
The physicians and staff at Family Medical Centers look forward to assisting you with your healthcare needs. It is our intention to make your visit as pleasant and convenient as possible. To reduce wait time and facilitate your appointment at any of our 11 area locations, we’ve provided these important forms online for your convenience.
Please review the following information, print forms and bring them with you to your next appointment.
This document covers our payment policies and will need to be read and signed upon your first visit.
Download FormThis notice describes how medical information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.
Download FormInstructions: Please review, sign and bring to your first appointment.
Download FormInstructions: Please fill-out and bring to your first appointment.
Download FormInstructions: Please fill-out and bring to your first appointment.
Download FormInsurance Plans Accepted
- Aetna (HMO & PPO)
- AARP
- AvMed
- Beechstreet Health Plans
- Cigna
- Coventry
- Devoted Health
- Evolutions Healthcare
- Florida Blue
- Gator Group
- GENEX / Choice Provider Network
- GHI
- Heritage Summit
- Medicaid
- Medicare
- Medicare Railroad
- Molina
- Multiplan
- PHCS
- Care Plus (Duval County locations only)
- PUP Medicare
- Rockport
- Secure Horizons
- Simply Healthcare
- Tricare
- United Healthcare Medicare
- Wellcare
- Worker’s Compensation
Coastal has ownership in the following entities: Coastal Physical Therapy, Coastal Laboratories
Physicians Group Services, PA complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. View our policy here.
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