PROVIDERS FOR HEALTHY LIVING
  • 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
​Health Professionals may refer patients directly using the "Professional Referral Form" link below.  We will contact your patient directly to schedule an initial intake appointment.  We will contact you if we have questions or need additional information about the referral you submitted.
Professional Referral Form
Release of Information Form
Informed Consent for Treatment
Permission to Obtain Medical Treatment Form
Child/Adolescent ADHD Vanderbilt Teacher Diagnostic Form
Child/Adolescent ADHD Vanderbilt Parent Diagnostic Form

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