New Patient Forms

Half Sheet

Patient Registration Form

Patient History Form

Privacy Practices

Records Request Form


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ECHC Forms

Please download and print the patient registration and history forms. Fill them out and return them to our office at least two business days prior to your scheduled appointment. Include a list of any medications you are currently taking, copies of your insurance cards and driver’s license. If we do not receive your paperwork in time, it may be necessary to reschedule your appointment.

You may use the records form on this page to request that your records be sent to us from a former doctor. If you want us to request your records from a former doctor or medical facility, be sure to bring us all necessary contact information for that doctor/facility.


918 Rolling Acres Road, Suite One, Lady Lake, Florida 32159
Phone: 352-259-1991 | Fax: 352-259-5540 | Email

Copyright 2007-2011 Dr. Vivian J. Woodard M.D. | All Rights Reserved

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