NEW PATIENTS
If you are searching for a primary care physician and in need of the best possible healthcare, you have come to the right place.Richichi Family Health is currently accepting new patients. Please stop by our office or complete the following registration packet and fax it to (239) 593-0067. You can also email the registration packet to info@richichihealth.com.
NEW PATIENT FORMS
Notice of Privacy Practices (Please read prior to signing the consent form)
New Patient Registration Packet
Medical Records Release
ESTABLISHED PATIENT FORMS
Pre-Appointment Questionnaire
Change/Update Patient Information
Advance Beneficiary Notice of Non coverage (ABN)
INSURANCE PLANS
The following is a summary of insurance plans we participate with and is subject to change without notice. If your insurance is not listed
here, please contact your insurance company to verify if Richichi Family Health providers are participating with your insurance company: