Interested in becoming a patient of Practitioners in Motion?

Once the forms are downloaded, please print them and complete all sections in full. When finished, you may return them to us by fax at (321) 216-2255 or by email at PractitionersinMotion@pimnp.com.

As you’re completing the counseling forms, please keep in mind that Matthew is available only at certain facilities.

If you have any questions or need assistance at any point, please don’t hesitate to reach out—we’re happy to help!