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.

  • New Patient Paperwork

    Click to Complete

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.

  • Medical Release Form (TO NBWC)

    Click to Complete

  • Medical Release Form (FROM NBWC)

    Click to Complete

OFFICE HOURS

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