Carlos F. Rodriguez, MD

Family Practice

5350 University Parkway, Ste. 101
Sarasota, FL 34243
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Phone: (941) 917-4675

Fax: (941) 917-4688

Education: Juan N. Corpas School of Medicine, Colombia

Internship: University of Arkansas, Fort Smith, AR

Residency: University of Arkansas, Fort Smith, AR

Certifications: American Board of Family Medicine

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Print Your Forms and Save Time

Please print & complete documents 1-5

1A. Adult Health History Questionnaire

or

1B. Pediatric Health History Questionnaire

2. New Patient Registration

3. Consent for Treament

4. Consent to Leave Messages

5. Authorization to Release Medical Records

*Some additional paperwork must be completed at office

Medicare Annual Wellness Visit

1. Health Risk Assessment (HRA)

Reference Documents

1. Notice of Privacy Practices

2. Making Personal Choices Information

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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About
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