Patient Forms

Demographic Sheet

The Demographic Sheet contains important information about you. Please fill it out completely and bring it to your initial office visit.

Financial Policy

The Financial Policy is a statement about billing responsibilities. It is also an authorization to provide your insurance company with information in order to process your claims. Please review and sign this document for your first appointment.

Release of Information

The Release of Information form allows Bach and Godofsky Infectious Diseases to obtain or release private health information. This signed form can be sent via fax to (941)746-3433 or brought directly to the office.

Patient History

Please access the patient portal to fill out online. This will decrease the pre-visit time in the office. Click here for Portal Access!

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Non-Emergency Infusion 
(941) 847-4603

M-F: 7:30am – 4:00pm
Weekends: 7:30am – 12:30pm

Patient Portal Is Here

Patient Portal

You can access your labs, request or cancel appointments, request medication refills and communicate securely with your healthcare provider.