Patient Registration Form – Click here to download

Please fill out the Patient Registration Form above. You can attach the completed document to the form below and submit, you can email the form directly to, or you can bring it with you to the office on your visit. If you have any questions please call (772) 873-6700 and we will provide you with any details needed.


Your Name (required)

Your Email (required)

Your Phone

Attach Patient Form:



Our facility is Medicare Certified and is licensed by the State of Florida. We are also accredited by AAAHC.


Monday: 7:30am - 5:00pm
Tuesday: 7:30am - 5:00pm
Wednesday: 7:30am - 5:00pm
Thursday: 7:30am - 5:00pm
Friday: 7:30am - 5:00pm
Saturday: Closed
Sunday: Closed


Address: 6830 S US Hwy 1
Port St Lucie, FL 34952
Phone: (772) 873-6700
Fax: (772) 465-5499

Copyright by Blue Water Surgery Center 2016. All rights reserved.