PROVIDERS FOR HEALTHY LIVING
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We are glad that you have entrusted us with your care. We strive to live up to our goal of instilling hope into every interaction with you.

​If you need a medication refill, ADHD rating scales for you or your child's teachers, or a release of information form, the links are located below.

As always, we appreciate and welcome your feedback, so feel free to send us an email if there are other items you'd like to see in this section of our website or have suggestions about how we can improve our services or operations.
Medication Refill Request Form
Release of Information Form
Permission to Obtain Medical Treatment Form
Notice of Privacy Practices
Informed Consent for Treatment
Vanderbilt (ADHD) Rating Scales for Parents
Vanderbilt (ADHD) Rating Scales for Teachers

Click Here to Complete a New Patient Registration Form Today and Get Help Soon!


LOCATED AT 341 N MAITLAND AVE, STE 340, Maitland, fl 32751

Telephone and fax -
​407-219-3281

Email (do not use for medication refill requests or in emergency situations) - patient@providersforhealthyliving.com

  • Home
  • Our Services
  • Virtual Visits
  • Meet Our Team
  • Location/Address
  • New Patient Information
  • Insurances Accepted
  • Current Patient Information
  • Make a Payment
  • Refer a Patient
  • Patient Feedback
  • Career Opportunities