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Us, At :

(954) 242-0576

6620 Lake Worth Road Unit C

Lake Worth, FL 33467

(561) 641-1111

Online Forms

Active Family Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, click here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Health History Form - Required

This lets us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

Download & Print Form



Download the Free Adobe Reader®

Contact Us

We Look Forward to Hearing From You

Locations


Office Hours

Monday:

9:00 AM-5:00 PM

Tuesday:

10:00 am-5:00 PM

Wednesday:

9:00 AM-5:00 PM

Thursday:

Closed

Friday:

9:00 AM-5:00 PM

Saturday:

By Appointment Only

Sunday:

Closed