IMPORTANT: DO NOT SUBMIT PERSONAL HEALTH INFORMATION (PHI) THROUGH THIS FORM
This form is intended for general, non-medical inquiries only.
Please do not include any personal health information, including:
- Medical conditions or symptoms
- Medications or treatment details
- Test results or diagnoses
- Insurance or identifying information (e.g., date of birth, Social Security number)
This form is not secure and is not monitored by clinical staff. We are unable to respond to medical questions or discuss patient care through this channel.
For medical questions, appointment needs, or to speak with a member of your care team, please call our office at 850-354-8765.
If you are experiencing a medical emergency, call 911 or go to the nearest emergency department immediately.