Online Registration Request a Consultation

Online Registration2018-12-06T12:55:44-07:00

Patient Registration

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the ‘Submit’ button at the bottom to automatically send us your information. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Take The Next Step

To schedule your consultation, please fill out the form on this page or call Dr. Schalit’s office at 386-437-6885 (Palm Coast) or 386-252-6438 (Daytona Beach).

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