P: 321-216-2288 | F: 321-216-2255

Practitioners in Motion
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P: 321-216-2288 | F: 321-216-2255

  • Home
  • Services
  • Meet our Team
  • Sponsor Events
  • Become a Patient
  • Contact Us
Now Accepting New Patients!

Becoming a Patient

 Interested in becoming a patient of Practitioners in Motion?


What you will need:


  • Health History Information
  • Insurance Information and our Consent
  • Pharmacy information (Including Phone #, Address)


Please click on the link below to fill out our patient consent and health history information. 

Patient Consent and Heath History Forms

Click Download to get started!

Once downloaded, please print, and fill out the form.  Then send via fax to (321) 216-2255, or email to PractitionersinMotion@pimnp.com

Practitioners in Motion Consent + HIPAA form (pdf)Download
Informed Consent For Counseling 2025 (pdf)Download

Connect With Us

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  • Become a Patient
  • Contact Us

Practitioners in Motion

1785 Waverly Pl Suite A Melbourne FL, 32901

E: practitionersinmotion@pimnp.com P: 321.216.2288

Copyright © 2015- Practitioners in Motion - All Rights Reserved.

Bringing Medical Care to You