218 Pasadena Ave S, St Petersburg, FL 33707
Mon to Fri 8:30AM to 5:00PM

FORMS

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 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
  • One of our physicians - Dr. Vijaya Cherukuri, Dr. Akila Ananthakrishnan or Dr. Consuella G. Margineanu - is your Primary Care physicians
  • Co-pays are due at the time of service - we accept all major credit cards