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New Patient Forms

Thank you for choosing CAN Community Health.  To expedite the patient registration process, and allow us to provide quality medical care, please print and complete this new patient packet in its entirety.  Please fax the completed forms back to our secure fax (941-951-1795) or mail them to CAN Community Health/Attn: Care Connection Team, 1231 N. Tuttle Ave, Sarasota, FL 34237. If you prefer to send these forms to us electronically, please email careconnectionteam@cancommunityhealth.org.

If you are unable to complete these forms prior to your visit, please arrive at least 15 minutes in advance of your appointment to complete them in our office.  Thank you again for choosing CAN Community Health to provide your care.

Please Click here to Download the New Patient Forms

When it comes to your health information, you have certain rights.
Click the link below for an explanation of your rights and some of our responsibilities to help you

Download the Patient Rights PDF