Patient Paperwork

North Broward Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.



Medical Release Forms

The forms below are used to authorize your medical records to be released to or from North Broward Wellness Center. Please select the one applicable to you, and fill out all available fields. If you are not sure if this applies to you, or if you have any questions, give our office a call at (954) 426-1100.

Monday
9:00am - 1:00pm
3:00pm - 7:00pm


Tuesday
3:00pm - 7:00pm


Wednesday
9:00am - 1:00pm
3:00pm - 7:00pm


Thursday
3:00pm - 7:00pm


Friday
9:00am - 1:00pm
3:00pm - 7:00pm


Saturday
9:00am - 1:00pm


Sunday
Closed

North Broward Wellness Center

6550 N State Rd 7
Coconut Creek, FL 33073

P: (954) 426-1100
F: (954) 426-4208