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  • COVID-19 Pre-Screening General Health Form

    Thank you for choosing Doctors United Group. The safety of our clients, team members and the communities we serve is our overriding priority. As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve and spreads globally, we are closely monitoring the situation and will periodically update company guidance based on current recommendations from the CDC and World Health Organization. To prevent the spread of COVID-19 and reduce the potential risk of exposure to our clients and team members, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in this building.
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  • Questionaire (all fields required)

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  • Assumption of Risk and Liability

    If you answered “Yes” to more than one of the questions listed above, access to our facility will be denied at this time.

    We thank you for your understanding in keeping you, our staff, and our community safe.

  • **By Signing this document you are certifying that, to the best of your knowledge, all information is correct as indicated and you are healthy to work on site.

  • Miami Dade

    1498 NW 54th Street Suite C | Miami, FL 33142 | 305.603.8200

    714 NW 62nd Street | Miami, FL 33150 | 786.485.3885

    Hialeah

    2150 W 76th Street Suite 100 | Hialeah, FL 33016 | 305.530.8949

    4212 W 16th Avenue | Hialeah, Fl 33012 | 305.821.552

    Homestead

    974 Old Dixie Highway | Homestead, FL 33030 | 786.349.4290

    Broward

    3215 NW 10th Terrace | Fort Lauderdale, FL 33309 | 954.530.3586

    Orlando

    3300 W Colonial Dr Suite 142 | Orlando, FL 32808

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