Home
Dr. Francis Conidi
Services
Patient Info
Insurance Info
Locations/Contact Info
Patient Education
Clinical Trials
Neurology Grand Rounds
News

Patient Information

Your First Appointment | Patient Forms
Privacy Practices

Your First Appointment

Please arrive early so that we can complete your initial paperwork. Also, please bring the following:

• Patient's insurance card
• List of current prescriptions and/or over-the-counter medication, including dose and frequency, as well as the name and address of pharmacy including mail order
• Information about patient's medical and surgical history
• Recent test results, x-rays, MRI's and/or relevant records (on disk form if available)

Patient Forms
[ PDF Help ]

• Handicap parking application [PDF]
• Headache questionnaire [PDF]
• Medical Records release [PDF]
• New patient registration [PDF]
• Office Policy [PDF]
• Pain questionnaire [PDF]
• Prescription Policy [PDF]
• Physician authorization for medication - Martin County [PDF]
• Physician authorization for medication - St. Lucie [PDF]
• School medication policy - St. Lucie [PDF]
• Standard disclosure and acknowledgement [PDF]

Privacy Practices

Our Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. It is given to all new patients, and a copy is available upon request.

HIPAA Privacy Policy Information

This is where you can feature something special about the practice, highlight a new service, link to a news article, etc.

---

This is where you can feature something special about the practice, highlight a new service, link to a news article, etc.