1500 Dr. MLK St. North, St Petersburg, FL 33704
Phone: 727-822-1555, Fax: 727-822-1777
Email: info@rubinhealthcenter.com

Patient Forms

Please print and complete the following forms and bring them to your appointment at Rubin Health Center.

  • New Patient Application (please also bring the Symptom Survey Form)
  • Symptom Survey Form
  • ACN - for United Healthcare and Great West patients