ALMA LEMEZ M.D.

Forms

Adult New Patient

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For adults (age 16+)

• English
• Spanish

Pediatric New Patient

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For children (age less than 16)

• English
• Spanish

Medical Information Release

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Authorizes Alma Lemez, M.D,P.A, to release your medical information to specific entities.

• Medical Release

Preparticipation Physical Evaluation

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Form is for Sports Physicals

• Preparticipation Physical Evaluation Form