Lake Howell Internal Medicine

New Patients

Please print and fill out these forms to bring to your first appointment.

Health History form
Confidential Patient Information form
Dr. Belnick HIPPA Consent Form
Dr. Rhodes HIPPA Consent Form

NOTE: You will need the free Adobe Reader software to open these forms. To download this software, click here.




If you are experiencing a medical emergency, please call 9-1-1 immediately.