Patient Forms

New Patients

To help reduce your waiting time, you can print and complete the below forms prior to your office visit.
Please bring them with you, rather than mailing or faxing them to us. Please complete all forms.

Additional forms:

  • Skincare Questionnaire & Waiver
  • Hormonal Imbalance Questionnaire for Women
  • Hormonal Imbalance Questionnaire for Men

If you need any assistance with these forms please feel free to call (352) 243-3555

Your medical records are completely private. To ensure patient confidentiality, and conforming to HIPAA regulations, no information regarding your condition will be released by this office to anyone, including any family member, without your written consent.

Medical Records Release Form

If you need any assistance with this form please feel free to call SunCoast Premier Medical @ (352) 243-3555

Medical Services in Clermont

  • Internal Medicine (Family Medicine)
  • Medical Weight Loss (Medications, Injectables)
  • PRP- Plasma Treatments - Botox
  • Lipo Sculpture
  • Wellness Physicals
  • Laser Procedures (Hair Removal, Skin Tightening)
  • Bio-Identical Hormonal Replacement Therapy
Learn More

Office Hours

Mon - 8:00am - 5:00pm Tue - 8:00am - 5:00pm Wed - 8:00am - 4:00pm Thu - 8:00am - 5:00pm
Fri - 8:00am - 4:00pm

Closed for lunch
12:00pm - 1:00pm

Clermont Office

SunCoast Premier Medical
Yvonne Rivera, MD
1239 US HWY 27
Clermont, FL 34714 Office: (352) 243-3555
Fax: (352) 243-6614

Davenport Office

SunCoast Premier Medical
Mario Perez, MD
43378 US HWY 27
Davenport, FL 33837 Office: (863) 420-8384
Fax: (863) 420-8619