Surterra Patient Recommendations Patient Name(Required) First Last Phone(Required)Email(Required) Nearest Clinic Location(Required)UnknownBoca RatonBradentonCarrollwoodCasselberryFernandina BeachFort WaltonGainesvilleJacksonville BeachKissimmeeLakelandNaplesOcalaOrange ParkPanama CityPensacolaPort CharlottePort St. LucieSt. PetersburgSun City CenterTallahasseeTampaThe VillagesWinter HavenDoes the patient have a Registry ID Card?(Required) Yes, the patient has an active card at this time. No, the patient does not have a card at this time. The patient has had a Florida card in the past, but it is not currently active. Other Employee Name(Required) Notes
