UF Health Archer Family Health Care: Before Your Visit
Please print, fill out these forms and bring them with you to Archer Family Health Care at your first appointment.
- Acknowledgment of Receipt of Notice of Privacy Practices (PDF)
- Adult Health History (PDF)
- Attachment V: Primary Care Authorization for Health Care Services and Participation Agreement (PDF)
- Collection and Use of Social Security Numbers (Archer Family Healthcare) (PDF)
- Collection and Use of Social Security Numbers (UF) (PDF)
- Consent and Authorization (PDF)
- Living Will (PDF)
- Review of Symptoms (PDF)
- Social History (PDF)
- X-Rays/Diagnostic Tests (PDF)
Request an Appointment
Specialties
Conditions & Services
- Acute illness management
- Asthma
- Diabetes
- General medical care
- Health screenings for men age 65 and older
- Health screenings for men ages 18 to 39
- Health screenings for men ages 40 to 64
- Health screenings for women age 65 and older
- Health screenings for women ages 18 to 39
- Health screenings for women ages 40 to 64
- High blood cholesterol levels
- High blood pressure and diet
- Minor surgical procedures
- Physical examination
- Pregnancy care
- Psychiatric services
- Vaccines (immunizations)
Accepted Insurance
We are a Blue Cross and Blue Shield, United Healthcare, Avmed, Cigna Aetna, Medicare and Medicaid Approved Provider. For patients with little or no income, fees are charged on a sliding scale based on family income.
