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Call Us Today

954-577-6161
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Request Appointment

Request Appointment

Hello.  I'm Carrie Norton, Office Manager/Chiro­practic Assistant, at Plantation Medical Rehab & Wellness.  I  look forward to meeting you at your upcoming appointment.  Plantation Medical Rehab & Wellness offers our patient form(s) online so you can complete it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or, if you prefer,  bring it with you to your appointment.
        Our fax number is 954-577-4447.

Auto Accident and Personal Injury ­ ­
(Please be sure to download and print form parts 1 and 2)

Download & Print Form part 1

Download & Print Form part 2­


Health Insurance
(Please be sure to download and print form parts 1 and 2)

Download & Print Form part 1

Download & Print Form part 2


Self Pay Patients

Download & Print Form


Workers Comp

Download & Print Form


Email Privacy Policy Form

Download & Print Form


Member Wellness Registration Form

This form can be filled out to register for access to the member wellness section of our website. You can also sign up for our monthly newsletter to keep up on current health issues and news and events in our office. You can print it out and bring it in to our office or Click Here to register online! The online newsletter sign-up is also on the right. We look forward to making your experience with our office and website more interactive and rewarding!

Download & Print Form



Download the Free AdobeReader®

Services
We strive to provide complete care for our patients. Learn about all the services provided at Plantation Medical Rehab & Wellness.
Make An Appointment
Request an appointment online for Plantation Medical Rehab & Wellness. We will do our best to accommodate your busy schedule.
Online Forms
Our patient forms are available online so they can be completed in the convenience of your own home or office.