Jane Fischer, DNP, APRN

Dermatology

5350 University Parkway, Suite 200
Sarasota, FL 34243
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Phone: (941) 917-8300

Fax: (941) 917-4023

Education: University Florida, Gainesville, Florida

Certifications: American Academy of Nurse Practitioners; Adult, Family, and Dermatology NP, Board Certified

Print Your Forms and Save Time

Please read in full prior to completing paperwork

New Patient Letter

Print & complete documents 1-5

1. Dermatology Health History Questionnaire

2. New Patient Registration

3. Consent for Treatment

4. Consent to Leave Messages

5. Authorization to Release Medical Records

*Some additional paperwork must be completed at office

Reference Documents

1. Notice of Privacy Practices

2. Making Personal Choices Infomation

3. Living Will Documentation

FPG Navigator

A password-protected Web portal that gives you 24-hour access to certain personal health information from your FPG medical record. You can also use it to pay your bills online and communicate with your care team. For urgent requests, phone your doctor’s office. Call 911 for emergencies. << Click for a helpful portal guide FPG Navigator is only compatible with Internet Explorer 9 and above.

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Contact

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact Sarasota Memorial Health Care System Public Relations Offices by phone or in writing:

ADMINISTRATION OFFICE:

1700 S. Tamiami Trail (mailing address); 1900 S. Tamiami Trail (physical address)

PRIVACY POLICY:

Please click here to read our Privacy Policy. | Nondiscrimination Statement

CONSUMER DATA:

Agency for Health Care Administration
Centers for Medicare / Medicaid Services