Welcome to Jacksonville Nephrology
We are here to help make your office visit as smooth as possible. For your convenience please find PDF downloadable forms that you can print and fill out prior to your office visit. We make every effort to mail the forms to you after an appointment is made, however given our desire to make an appointment as soon as possible it is not always feasible to mail the documents. Therefore, please use the following forms. If you are unable to download the forms please let our office know so that they can be ready for you when you arrive.
New Patient Documents
Medical History Form
If you have medical records with another physicians office, please complete the Medical Records Release Authorization below so that we may obtain those records.
Medical Records Release Authorization
We have exciting news regarding your healthcare!
As we continue in our efforts to provide you, our patients, with the highest quality of care, we are constantly looking for methods of working together with you to ensure that you are not only aware of, but also involved in the maintenance and improvement of your health.
To that end, we are proud to announce that our practice offers you the opportunity to use the power of the web to track all aspects of your health care through our office. The patient portal enables our patients to communicate with our practice easily, safely, and securely over the internet.
Current patients click HERE for access to your portal.
If you are a current patient and would like to gain access, please contact our office today so we can help you.
You can now view your account balance and make a payment through your patient portal.
We understand your time is valuable and make every effort on our end to make your office visit more about your medical care than about paperwork. The list below is what we need from you on your first office visit.
Notify our office of any changes in address, phone number or insurance coverage as soon as possible. You can update your information via your Patient Portal at anytime.
As a current patient we will confirm your personal information (address, phone number, insurance coverage, etc) each time you visit via our computer based check-in tablet.
Options for End Stage Renal Disease
We understand the need to better understand the options available to you. This is a 20 minute video that explains the options to help you empower yourself.