Reliable MD’s mission is to provide health & well-being services based on the community’s needs by providing affordable and personalized high-quality medical care.
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Forms
Welcome to Reliable MD the Community and Family Health Specialist. We look forward to meeting you in person and resolving your Health issues. Please see guidance and form options below so we can be prepared to assist you:
- If you were referred by another provider’s office, please obtain a referral if one is required by your insurance.
New Patient Information Form
Record Release
Patient Referrals
Medical History Form
Forms should be completed as much as possible and then faxed to 727-203-4613. If you have any questions regarding the forms please feel free to reach out directly to our Health Center 727-203-4613. We are here to help you. Our phone/fax number accepts both voice and fax calls and is HIPAA Compliant.
Our Mission
Reliable MD’s approach is to first assess a patient’s health through a thorough physical examination. We have found that the results of this method typically unveil any past or current issues that may have been neglected. Starting off with a physical examination of your health is a natural approach that allows our team to review your vaccinations, current ailments or injuries, and medical prescriptions as well.
