Important Notice: No Soliciting

This appointment request form is for patients and their representatives only.

Do NOT use this form to solicit services, offer products, or send marketing messages.

Unauthorized use may violate Florida law (Fla. Stat. § 501.201) and HIPAA regulations. All IP addresses are logged. Violators will be reported and blocked.

* indicates a required field

Email *

Phone *

Message *

Full Name *

Insurance Company *

Insurance Number *

I agree to be contacted by Horizon Care Services LLC by Phone, SMS, and Email.

Note: Please DO NOT apply for jobs here. Visit our Careers page for more information.