Patient Registration Forms

Bariatric and general surgeon Dr. A. Enrique Whittwell in Miami, Florida welcomes you to our practice. Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process.

Please be sure to bring all forms with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician.

Downloadable Forms:

New Patient Registration
Health History

Please note: It may take a few moments to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat Reader for free by clicking on the icon below.

REQUEST AN APPOINTMENT

Interested in scheduling an appointment with one of our providers?
Request an appointment online.