NEW PATIENT FORMS
Please print and complete all the following forms and bring them with you during your initial visit. Alternatively, you can mail them at least 3 days prior to your visit to the following address:
Premier Health Care, Inc.
Attn : Front Office
218 Pasadena Ave S
St. Petersburg, FL 33707-1251
Click on links to download Word or PDF Forms
Before you come to our office visit, please check the following:
Bring your current insurance card(s) – we are a participating provider on most insurance plans.
List of current medications with dosage strength.
Past medical history with physicians you have seen.
Dr. Vijaya Cherukuri is your Primary Care Physician.
Co-pays are due at the time of service – we accept all major credit cards.