Preparing
for a Visit
Forgot to tell the doctor
something important?
Having trouble remembering the doctor's instructions?
Use the form(s) below to prepare for your office visits.
PHONE NUMBERS
For Appointments: (727) 446-3346
BRING TO THE APPOINTMENT
Insurance Card, Co-Payment (due at time of appointment),
Previous Health Records, any payment due, list of all medicines, including
herbs and non-prescription.
WHAT YOU MAY BE ASKED
These two questionnaires below will open in separate
windows. Follow the instructions on each and close the window(s)
to return here.
First Time Visit or updating medical records
(Medical History Questionnaire): As a new or returning patient,
you have a lot of background to share with Dr. Battista. Fill out this
form online and print 2 copies (one for you and one for the doctor). Click
here to view the "Medical history" questionnaire.
Every Visit (Reason for Visit Questionnaire):
You and your doctor have a lot of information to share in a short amount
of time. To get the most from your visit, fill out this form online and
print a copy to take to your appointment. Click
here to view the "Reason for Visit" questionnaire.
ANTI-AGING
& FAMILY MEDICINE
©2005-9
JOHN M. BATTISTA, M.D. All rights reserved
JOHN
M. BATTISTA, M.D.
561 DUNCAN AVENUE SOUTH
CLEARWATER, FL 33756
(727) 446-3346
www.DoctorBattista.com
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