New Patient Registration Forms

Your first visit to First Choice Medical Group is important and can be most effective if you plan ahead.  To assist us in expediting the process when you arrive for your first appointment, please download, print and complete the following forms prior to your visit:


New Patient Registration Forms

To help us in best evaluating your condition, please also download, print and complete the form(s) below that relate to your specific medical concern(s) for which you are seeking treatment:Pain Assessment for the Spine

 

What Else to Bring
  • The designated patient registration forms listed above.  You will need to fill them out and bring them with you to your appointment.

  • Insurance card(s) and a photo ID.  If the appointment is for a minor, you will need to provide the parent's or legal guardian's insurance card(s) and photo ID.

  • Medical records.  Please bring relevant medical records from other physicians, results and copies of X-rays, and other imaging studies and lab test results.

  • Written lists of medications, herbs, vitamin supplements and over-the-counter medications that you are currently taking.

  • Your concerns.  Be prepared to ask questions or express concerns about your condition when you meet with our care team.

  • A family member or friend.  Considering asking a friend of family member to accompany you if you require assistance with walking, using the restroom or filling out paperwork.

  • Translator.  If you need a translator, ask another adult to come with you.  Please do not rely on a child to translate for you.

  • Comfortable clothing.  During your appointment, your care team may require X-rays or an MRI.  Wear loose clothing that it is easy to take off and put on.

 

First Choice Medical Group

General Orthopaedics, Orthopaedic Surgery, Neurology and Interventional Pain Management in Melbourne, Fl and Viera, Fl

First Choice Medical Group located in Melbourne, Florida and Viera, Florida is dedicated to delivering state-of-the-art musculoskeletal diagnosis and treatment to ensure pain, discomfort, and dysfunction are readily resolved and the quality of life you are seeking is successfully attained. First Choice Medical Group's Board Certified clinical team includes five Orthopedic Surgeons and a Neurologist practicing General Orthopaedics, Orthopaedic Surgery, Sports Medicine, Neurology, and related Interventional Pain care. 

The Practice physicians include Anthony Lombardo, MD, FAAOS, Donald Vliegenthart, MD, ATP, Kenneth C. Sands, MD, FAAOS, Richard J. Harrison, MD, FAAOS, Dr. Raymond J. DeLorenzi, MD, FAAOS, and Richard P. Newman, MD, FAAOS.

Our world-class team of Orthopedic surgeons and medical staff provide compassionate care that is focused on each patient's full continuum of care, which requires a more personalized approach to treatment.  In fact, our care delivery practices exemplify the very definition of patient-centric care, explicitly recognizing the importance of human interaction in terms of personalized care, kindness and being "present" with patients.  Our caregivers will listen to and honor the perspectives of your choices; and they communicate and share complete and unbiased information with you in ways that are affirming and useful in your care decision-making processes. 

First Choice's patient-centric culture strives to include providing an inviting, easily accessible, peaceful, healing environment that is designed specifically to allay fear, anxiety, and discomfort.  We also take pride in utilizing the most advanced diagnostic technologies coupled with the latest in individualized care, including trigger point injections and pharmacological, physical, occupational, neurological and orthopedic treatment options.

 

Read more
First Choice Medical Group

First Choice Medical Group located in Melbourne, Florida and Viera, Florida is dedicated to delivering state-of-the-art musculoskeletal diagnosis and treatment to ensure pain, discomfort, and dysfunction are readily resolved and the quality of life you are seeking is successfully attained. First Choice Medical Group's Board Certified clinical team includes five Orthopedic Surgeons and a Neurologist practicing General Orthopaedics, Orthopaedic Surgery, Sports Medicine, Neurology, and related Interventional Pain care. 

The Practice physicians include Anthony Lombardo, MD, FAAOS, Donald Vliegenthart, MD, ATP, Kenneth C. Sands, MD, FAAOS, Richard J. Harrison, MD, FAAOS, Dr. Raymond J. DeLorenzi, MD, FAAOS, and Richard P. Newman, MD, FAAOS.

Our world-class team of Orthopedic surgeons and medical staff provide compassionate care that is focused on each patient's full continuum of care, which requires a more personalized approach to treatment.  In fact, our care delivery practices exemplify the very definition of patient-centric care, explicitly recognizing the importance of human interaction in terms of personalized care, kindness and being "present" with patients.  Our caregivers will listen to and honor the perspectives of your choices; and they communicate and share complete and unbiased information with you in ways that are affirming and useful in your care decision-making processes. 

First Choice's patient-centric culture strives to include providing an inviting, easily accessible, peaceful, healing environment that is designed specifically to allay fear, anxiety, and discomfort.  We also take pride in utilizing the most advanced diagnostic technologies coupled with the latest in individualized care, including trigger point injections and pharmacological, physical, occupational, neurological and orthopedic treatment options.

 


Read less

Hospital and Ambulatory Surgery Center Affiliations

Affiliations
  • Crane Creek Surgery Center

    2222 South Harbor City Boulevard, Suite 540

    Melbourne, Florida 32901

    Main Phone:  321-541-1776

     

    Health First Cape Canaveral Hospital

    701 W. Cocoa Beach Causeway

    Cocoa Beach, Florida 32931

    Main Phone:  321-799-7111

     

    Health First Holmes Regional Medical Center

    1350 South Hickory Street

    Melbourne, Florida 32901

    Main Phone: 321-434-7000

     

    Health First Palm Bay Hospital

    1425 Malabar Road, Northeast

    Palm Bay, Florida 32907

    Main Phone: 321-434-8000

     

    Health First Viera Hospital

    8745 North Wickham Road

    Melbourne, Florida 32940

    Main Phone: 321-434-9000

     

    Melbourne Same Day Surgery Center

    1035 South Apollo Boulevard

    Melbourne, Florida 32901

    Main Phone: 321-434-7216

     

    Melbourne Surgery Center

    95 Bull Dog Boulevard, Suite 104

    Melbourne, Florida 32901

    Main Phone: 321-729-9493

     

    Sebastian River Medical Center

    13695 US Highway 1

    Sebastian, Florida 32958

    Main Phone: 772-589-3186

     

    Wuesthoff Medical Center Melbourne

    250 N. Wickham Road

    Melbourne, Florida 32935

    Main Phone: 321-752-1200

     

    Wuesthoff Medical Center Rockledge

    110 Longwood Avenue

    Rockledge, Florida 32955

    Main Phone: 321-636-2211

Insurance

At First Choice Medical Group, our staff aims at providing every patient with the highest quality healthcare. If you have any questions about the insurance policies we accept, please call our office. We are proud to partner with you to help you afford the healthcare that you need.

Aetna
AmeriGroup
Blue Cross Blue Shield
CarePlus Health Plans (Florida Medicare)
Choice Care Network
Cigna
Clear Health Alliance
Coventry Health Care
GHI
HealthEase
HealthFirst
Humana
Multiplan PHCS
POMCO
Tricare
United Healthcare
Our Locations

Choose your preferred location