Risk-Free Health Survey

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Risk Free! See if you qualify.

A recommendation is available to Florida residents who have been diagnosed with a qualifying condition. Simply complete the confidential eligibility survey, schedule an appointment with one of our Florida licensed and certified physicians who will immediately provide your recommendation. Get your card right away, don't wait any longer!

Fill out this eligibility survey to see if you qualify:

Name *

First

Last

Date of Birth *

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Email *

Email

Confirm Email

Phone *

Are you a Florida resident? *yesno

Zip Code *

How did you hear about us?Friend/FamilyFriend/FamilyEmailNewspaperDrive byGoogleBingInstagramMailerBillboardNextDoor.comTVTwitterYelpYouTubeOther

condition? Birth you

Medical Conditions

Please check any of the conditions you suffer from:

*

• NONE OF THESE
• AD/HD
• Anxiety Disorder
• Cerebral Palsy
• Cyclical Vomiting Syndrome
• Endometriosis
• Glaucoma
• Lupus
• Migraine
• Muscular Dystrophy
• Neuropathy
• Polymyalgia Rheumatica
• Premenstrual Syndrome (PMS)
• Rheumatoid Arthritis
• Spasticity

*

• NONE OF THESE
• AIDS/HIV
• Cachexia (Wasting Syndrome)
• Chronic Pain
• Degenerative Disk Disorder
• Epilepsy/Seizures
• Herniated Disk
• Irritable Bowel Syndrome
• Multiple Sclerosis
• Myositis
• Osteoarthritis
• Parkinson's Disease
• Reflex Sympathetic Dystrophy
• Scoliosis
• Spinal Stenosis

*

• NONE OF THE ABOVE
• Amyotrophic Lateral Sclerosis (ALS)
• Cancer/Tumor
• Crohn's Disease
• Diabetes
• Fibromyalgia
• Insomnia
• Lyme Disease
• Muscle Spasms
• Myasthenia Gravis
• Osteoporosis
• Post Traumatic Stress Disorder (PTSD)
• Restless Legs Syndrome
• Sickle Cell Anemia
• Other medical conditions of the same kind or class as those listed

Have you received previous treatment for your condition? *yesno

e.g. medication, surgery, counseling

Electronic Communications: *

• By using KindHealth's website, telephone, facsimile, send text messages or emails to us, you are communicating electronically. You consent to receive communications from us electronically. We will communicate with you by telephone, email, text message or by posting notices on this site. You agree that all agreements, notices, disclosures and other communications that we provide to you electronically satisfy any legal requirement that such communications be in writing.

Now, prove you are a human. *

What is 7+4?

Submit

Why a Health Survey?

When you visit KindHealth to evaluate your qualified condition, health surveys are critical in understanding patient needs and improving healthcare services. They enable patients to share their symptoms, experiences, and concerns, providing healthcare professionals with valuable data to make informed decisions. This feedback loop helps in tailoring treatment plans, identifying public health trends, and ultimately enhancing the quality of care. By actively participating in health surveys, patients contribute to a more responsive and effective healthcare system that can better address their specific health challenges and promote overall wellness.