727-507-8555
2878 Roosevelt Boulevard, Clearwater, FL 33760
Phone: 727-507-8555 Fax: 727-532-0091


International Health Clinic
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Listed below are client intake forms which needed to be filled out prior to the first appointment. You may download these forms and complete them in advanced to reduce waiting time upon your first visit:
(MS Word Document)
(PDF Document)
Insurance Verification Form. doc
(MS Word Document)
Insurance Verification Form.pdf (PDF Document)
Patient Registration/ Insurance Verification Forms

You may also submit these forms via fax at 727-532-0091 or email at acuandphy.gmail.com.