COVID-19 Advisory: We are taking every precaution necessary to help prevent the spread of COVID-19 while caring for our patients and protecting our team, including: universal mask use, temperature checks, social distancing, and verbal screening. Also offering telehealth appointments.

Forms

To assist you with any necessary documentation required to become a patient, transfer records in or out of the office, or for other medical tracking sheets, please choose from the following forms.

New Patient Packet – required for all patients prior to initial visit

Records Release Authorization – used to have records sent from Orlando Epilepsy Center to another office/location/Guardianship

Medical Records Request – used to have records sent to Orlando Epilepsy Center from another office

Prescription Pickup Authorization – used pick up a prescription for the patient, or patients’ authorized representative