Patient Information / Forms

Please PRINT and complete the following forms and bring to your first appointment with Dr. Tishko or Dr. Radecki.

Patient Registration Form

Patient History Form

Privacy Statement

Dr. Dennis J. Tishko, MD, FACS

Tel: 954-320-5758
Fax: 954-888-3808

1801 W. Sample Road, Suite 101
Deerfield Beach, FL  33064

1601 S. Andrews Rd, 3rd Floor
Ft Lauderdale, FL 33316

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