Patient Registration

Winter Haven Oral Surgery, Dr. Cornejo & Dr. Ramirez

You may preregister with our office by filling out our secure online Patient Registration Form. After you have completed the form, please make sure to press the submit button at the bottom to automatically send us your information. A green box should pop up letting you know your information was properly submitted. On your first visit to our office, we will have your completed form available for your signature. The security and privacy of your personal data is one of our primary concerns and we have taken every precaution to protect it.

Online patient registration button

We strive to exceed our patient’s expectations in every way. Call us Today!
Winter Haven Oral Surgery Phone Number 863-294-7648 Request an Appointment Map & Directions
Our office hours are Monday through Thursday: 8:00 AM - 4:30 PM and Friday: 8:00 AM - 3:30 PM.