Clermont Cardiology wants to make your visit as smooth as possible. That's why we've posted our patient paperwork online so you can complete it before your visit.


To assist us in making your visit as smooth as possible, please download and complete the first five documents listed. Bring the completed forms and your insurance card wtih you, on the day of your appointment.

Patient Information Sheet (PDF)
Health History (PDF)
Medication List (PDF)
Advance Directive (PDF)
Authorization to Transfer Confidential Information (PDF)

Echocardiogram (PDF)
Nuclear Stress Test Preparation (PDF)
Consent Form: Treadmill Dual Isotope Exercise Testing (PDF)
Consent Form: I.V. Adenosine Dual Isotope Stress Test (PDF)
Responsibility for Payment (PDF)


200 E. Highland Ave. Ste. 1 • Clermont, FL 34711 • Ph: 352.394.3611 • Fx: 352.394.0739
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