Patient Consent Form (EN)

Please complete the following form prior to your upcoming appointment.

If you need support completing this form, please contact us at (305) 902-6347.

(305) 902-6347

Mailing Address
1951 NW 7th Ave, Suite 300
Miami, FL 33136

If you experience a mental health emergency at any time, contact the Suicide and Crisis Lifeline by calling or texting 988.

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© 2023 Brave Health, Inc., Brave Health Medical Group, PA, and Brave Medical, PC are independent, affiliated organizations. The organization providing clinical services is dependent on the state of residence of the patient.