div class=trans-pagebutton class=gotoPage data-page=1Page 1button div class=trans-imageimg data-url=documentf-2017-01-05-florida-surgical-clinic-patient-information-patient-registrationhtmlpage=1 data-page=1 class=trans-thumb lazyload alt=Page 1: floridasurgicalcliniccom · 2017-01-05 · Florida Surgical Clinic PATIENT INFORMATION Patient Registration and Insurance Form 701 Manatee Ave W Suite 105 Bradenton FL 34205-8624 loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mM8Uw8AAh0BTZud3BwAAAAASUVORK5CYII= data-src=https:reader033fdocumentsusreader033viewer20220418065e5468f37ddcfb6cfd35c5b8html5thumbnails1jpg width=140 height=200 divdivdiv class=trans-pagebutton class=gotoPage data-page=2Page 2button div class=trans-imageimg data-url=documentf-2017-01-05-florida-surgical-clinic-patient-information-patient-registrationhtmlpage=2 data-page=2 class=trans-thumb lazyload alt=Page 2: floridasurgicalcliniccom · 2017-01-05 · Florida Surgical Clinic PATIENT INFORMATION Patient Registration and Insurance Form 701 Manatee Ave W Suite 105 Bradenton FL 34205-8624 loading=lazy src=data:imagegifbase64iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mM8Uw8AAh0BTZud3BwAAAAASUVORK5CYII= data-src=https:reader033fdocumentsusreader033viewer20220418065e5468f37ddcfb6cfd35c5b8html5thumbnails2jpg width=140 height=200 divdiv