Patient Forms

General Forms

• File

  HIPAA Privacy Notice - English (PDF)
• File

  Aviso Sobre Prácticas de Privacidad – HIPAA (PDF)
• File

  Notice of Nondiscrimination - English (PDF)
• File

  Declaración de no Discriminación (PDF)
• File

  Declaración del Paciente de Derechos y Responsabilidades (PDF)
• File

  Patient Rights and Responsibilities (PDF)
• File

  Disclosure Notice Regarding Patient Protections Against Surprise Billing (PDF)
• File

  Patient Rights Under Florida Price Transparency Act of 2016 (PDF)
• File

  Advanced Directives (PDF)

Florida Transparency Bill

• File

  Financial Policy (PDF)
• File

  Financial Verification Form NOSI - Plantation (PDF)

Services may be provided by other healthcare providers who may bill separately.

Quest
500 Plaza Dr.
Secaucus, NJ 07094
(888) 295-2584 

LabCorp
PO Box 2240
Burlington, NC 27216
(800) 845-6167