Now accepting Telehealth appointments. Schedule a virtual visit.

Patient Forms


The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit. Please be prepared to provide this information to our office along with your current medical insurance information. If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.

We understand the vicissitudes  of life,  so we  do not charge you  for “no shows”, but we will discharge any patients from the practice with multiple “no shows”. We pride ourselves in seeing a limited number of patients per day in order  to provide the best possible care to our  beloved patients. Any appointment time that is squandered deprives another  patient of the opportunity to be cared for.  Please carefully read the following policies so that you may be well informed of our mode of operations and practices.

Clermont Internal and Cosmetic Medicine, LLC.
290 Citrus Tower Blvd., Suite 102
Clermont, FL 34711
Phone: 352-404-5174
Fax: (855) 794-3370
Office Hours

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