Please Note: These documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.
- New Patient Registration Form (print, sign and bring with you)
- Annual Patient History Form (print, sign and bring with you)
- Notice of Privacy Practices
- Patient Consent Form (print, sign and bring with you)
Mohs Micrographic Surgery Forms:
- Mohs Surgical Consent Form (print, sign and bring with you)
- Mohs Surgery-Patient Guide (please review prior to surgery)
- Lakebridge Office Map and Directions
Post-Surgical Care Instructions
Co-payments and co-insurances are due at the time services are rendered. Forms of payment accepted by the office are check, cash, insurance assignment and most major credit cards.
Patient Portal-Online Payments
You may access your patient portal at https://community.carecloud.com and select FINANCIALS
- Aetna PPO
- AV‐Med (PHCS logo)
- Blue Cross Blue Shield
- Cigna PPO
- Coventry FirstHealth
- FloridaHeath Care TripleOptions/POS programs
- FloridaHospitalsHealth Care systems
- Golden Rule
- Humana Commercial PPO, POS, EPO, Medicare PPO, POS and Medicare Network PFFS plans
- Tricare standard
- United American
- UnitedHealth Care
We are Not providers for:
HUMANA HMO Or ANY Medicaid programs
FAQ: What is a PA-C or ARNP?
A physician assistant certified (PA-C) is a health professional licensed by the state or credentialed by a federal employer to practice medicine as delegated by and with the supervision of a physician. It means that the person who holds the title has passed the certification exam developed jointly by the National Board of Medicine Examiners and the National Commission on Certification of Physician Assistants (NCCPA). PAC’s can meet the needs of patients in a variety of clinical and hospital settings. They perform physical exams, diagnose illnesses, develop and carry out treatment plans, order and interpret lab tests, provide patient education and preventive health care counseling and prescribe medications. A PA-C typically has a bachelor’s degree and four years of health care experience. To maintain the “C” after the PA, a physician assistant must log 100 hours of continuing medical education every two years and take a national re certification exam every six years. This helps ensure there is a core medical and surgical knowledge that each PA-C should attain and maintain.
A nurse practitioner (NP) is an advanced practice registered nurse (APRN) who has completed advanced coursework and clinical education beyond that required of the generalist registered nurse (RN) role. According to the International Council of Nurses, an NP/advanced practice registered nurse is "a registered nurse who has acquired the knowledge base, decision-making skills, and clinical competencies for expanded practice beyond that of an RN, the characteristics of which would be determined by the context in which he or she is credentialed to practice."