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Alix Charles, DPM, PA
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    • Accepted Insurances
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  • More
    • Home
    • Contact Us
    • About Us
    • Services
    • Insurance
      • Accepted Insurances
      • Referrals
    • Appointments
    • New Patients
    • Blog
    • Store
      • Nerve Reverse
Alix Charles, DPM, PA
  • Home
  • Contact Us
  • About Us
  • Services
  • Insurance
    • Accepted Insurances
    • Referrals
  • Appointments
  • New Patients
  • Blog
  • Store
    • Nerve Reverse

New Patients

Is this your first visit?

There is no need to worry. Our registration process is easy and straight forward. On the day of your appointment, you will need to bring your insurance card and government issued picture ID (driver's license, permit, DMV issued ID card, passport, etc.). Minors may bring their school ID though they will need a guardian to accompany them. The guardian will also need to provide us with a government issued picture ID. 


To ensure that you are getting the care that you require, you will need to fill out and sign our NEW PATIENT REGISTRATION FORM as well as our MEDICAL RELEASE FORM. We have provided copies below that you may download and complete prior to your appointment. If you would rather wait until the day of your appointment, you may choose to do so as well. We will provide you copies of the forms to fill out in our office.


If your insurance is HUMANA, HEALTHSUN, AMBETTER VALUE, AMBETTER VIRTUAL ACCESS, CAREPLUS OR VETERAN AFFAIRS, you will need a referral (click here for more information on the referral process). You may either download the referral request form below and send it to your primary care physician or call us ahead of your appointment to complete the process for you. 

Downloads

HUMANA/SOLIS/HEALTHSUN PATIENTS ONLY - REFERRAL REQUEST FORM - NEW PATIENT (pdf)Download
MINOR CONSENT TO TREAT FORM (pdf)Download
MEDICAL RECORD RELEASE FORM (pdf)Download
PATIENT REGISTRATION FORM (pdf)Download
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Alix Charles, DPM, PA

810 South State Road 7, Plantation FL 33317

(954) 766-4384

Copyright © 2025 Alix Charles, DPM, PA - All Rights Reserved.

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