New Patient Forms

First Visit

New Patient Forms

Completing your forms is the first step toward scheduling your first appointment.

Three ways to complete your forms

  • Fill out the fillable PDF electronically
  • Print and complete by hand
  • Pick up a paper packet at the office

Submit by

  • Email — drj@sethjarrellmd.sprucecare.com
  • Fax — (256) 767-5943
  • Mail or drop-off — 204 Ana Dr, Suite B, Florence, AL 35630

Download New Patient Forms (PDF)

Insurance

For most insurance plans, no referral is needed. Some plans — including BCBS/Obamacare plans — require a referral from your primary care physician before your first appointment. We accept Medicare.