Forms

Choose from the following new patient forms.

Downloadable Forms

Patient Demographics

Health History

General Consent Form

Pelvic Examinations Consent Form

Release of Medical Information

HIPAA Form

Electronic Forms

New Patient Electronic Forms Package

Elite Women's Care: Dr. Lauren Juyia, GYN and staff is dedicated to the well-being of our patients while providing quality healthcare for women of all ages.

Operating Hours

Monday - Friday: 8am - 5pm
Saturday & Sunday: Closed

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Brooksville Location

11319 Cortez Blvd
Brooksville, Florida 34613
Phone: 352.345.4456
Fax: 352.835.7740

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Clearwater Location

1801 N Belcher Rd., Ste. A
Clearwater, Florida 33765
Phone: 352.345.4456
Fax: 352.835.7740