2426 South Tamiami Trail
Sarasota, FL 34239

Tel: (941) 906-7546

3195 Harbor Blvd.
Port Charlotte, FL 33952

Tel: (941) 743-7546


Patient Forms and Other Helpful Resources

Patient Resources

Patient Forms

(These forms are provided for your convenience so that you may complete them at your own leisure. Please bring the completed forms with you on the day of your appointment. Thank you.)

Click here to download the Patient Forms

Office Hours

We are open Monday - Friday, 8:00 a.m.- 5:00 p.m.

Cancellation Policy

We are aware of and sensitive to the fact that an emergency may occur in a rare instance, preventing you from keeping your scheduled appointment. However, cancellations, especially last minute ones, along with patient no-shows, limit our ability to accommodate the scheduling needs of other patients. We therefore ask for your full cooperation with the following policy.

  • If you are unable to keep a scheduled appointment, we request that you notify us no later than one full working day prior to your appointment, so that your appointment may then be rescheduled.
  • If you accumulate 3 cancellations or no-shows, we may place you on a "schedule based on availability" list. This will require you to call for an appointment on each day you would like to be treated; we will do everything possible to accommodate you, as space on the schedule permits.

This policy is necessary for the benefit of all our patients, so that we may continue to provide high quality treatment and service to everyone. We appreciate your anticipated adherence and cooperation with this policy.

Insurance Information

  • BCBS Blue Card PPO
  • First Health PPO
  • Great West PPO
  • Pacificare PPO
  • Aetna Choice PPO
  • CIGNA Open Access
  • UHC Choice Plus POS
  • UHC Options PPO
  • HealthNet CA Large Group PPO

Please contact your carrier to verify that Dr. Fernandez is on your particular plan. Insurance information is subject to change at any time.


We accept Visa, Mastercard, and Discover.