New Patient Paperwork

Breakthrough Healthcare offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them...
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

All Nutrition Patients, please fill out the following forms:


All Autistic Patients, please fill out the following forms:


All Neuropathy Patients, please fill out the following forms:


Additional Forms:

NEW PATIENT
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OFFICE HOURS


Monday
8:30am - 12:00pm
2:00pm - 5:00pm


Tuesday
8:30am - 12:00pm
2:00pm - 5:00pm


Wednesday
8:30am - 12:00pm
2:00pm - 5:00pm


Thursday
2:00pm - 5:00pm


Friday
8:30am - 12:00pm


Saturday
CLOSED

Breakthrough Healthcare
11481 Old St Augustine Road
Jacksonville, FL 32258
(904) 260-1993

ADDRESS

11481 Old St Augustine Road Jacksonville, FL 32258

EMAIL

Click HERE to Email Us