Accessibility Tools
Contact to Dr. J. Pieter Hommen - Orthopedic Surgeon & Sports Medicine
X

Initial Patient Forms

At the time you make an appointment with our office, you will provide an email address and the last four of your social security number. Shortly after your appointment is made, you will receive a separate email asking to register with our patient portal. Please click the link provided in the email and follow the directions:

To register with the portal, you must verify your identity:

  • First Name
  • Last Name
  • Date of Birth
  • Last four of your Social Security Number

Benefits of our online portal:

  • Access to Therapy and MRI prescriptions
  • Message our Office
  • Office Visit Notes
  • View Upcoming Appointments

Once registered, you will be able to complete the online Health History questionnaire. It will automatically upload to your file for your visit with us. In addition to the online Health History questionnaire, we have two additional forms you will be asked to complete and bring to your initial visit:

If you do not have a valid e-mail address or you did not receive the link, please print out this form below and bubble in the appropriate answers and return to our office.

If you are already registered click here to access our online portal.

 

You will need the Adobe Reader to view and print these documents. Get Adobe Reader

Location of Dr. J. Pieter Hommen - Orthopedic Surgeon & Sports Medicine

7800 SW 87th Avenue
Suite A110, Miami, FL 33173

Office Hours

  • Monday - Thursday : 8:30 am - 5:00 pm
  • Friday : 8:30 am - 3:00 pm

Contact

Tel : 

Fax : (305) 520-5628

[javascript protected email address]

Follow Us

  • Baptist Health South Florida
  • Mercy
  • Miami Surgical Center
  • webpage api button