lp.adventhealth.com
Open in
urlscan Pro
104.126.37.129
Public Scan
Submitted URL: https://adventhealthorthoeastfl.com/
Effective URL: https://lp.adventhealth.com/eastflua/orthopedic-general/
Submission: On July 06 via api from US — Scanned from DE
Effective URL: https://lp.adventhealth.com/eastflua/orthopedic-general/
Submission: On July 06 via api from US — Scanned from DE
Form analysis
1 forms found in the DOMPOST https://adventhealth.formstack.com/forms/index.php
<form method="post" accept-charset="UTF-8" novalidate="" enctype="multipart/form-data" action="https://adventhealth.formstack.com/forms/index.php" class="fsForm fsMultiColumn" id="fsForm3510683">
<input type="hidden" name="form" value="3510683">
<input type="hidden" name="viewkey" value="ZMgk4VeWDm">
<input type="hidden" name="displayTime" value="2024-07-06T09:07:33-04:00">
<input type="hidden" name="password" value="">
<input type="hidden" name="hidden_fields" id="hidden_fields3510683" value="">
<input type="hidden" name="incomplete" id="incomplete3510683" value="">
<input type="hidden" name="incomplete_password" id="incomplete_password3510683">
<input type="hidden" name="referrer" id="referrer3510683" value="https://lp.adventhealth.com/">
<input type="hidden" name="referrer_type" id="referrer_type3510683" value="js">
<input type="hidden" name="_submit" value="1">
<input type="hidden" name="style_version" value="3">
<input type="hidden" id="viewparam" name="viewparam" value="787875">
<div id="requiredFieldsError" style="display:none;">Please fill in a valid value for all required fields</div>
<div id="invalidFormatError" style="display:none;">Please ensure all values are in a proper format.</div>
<div id="resumeConfirm" style="display:none;">Are you sure you want to leave this form and resume later?</div>
<div id="resumeConfirmPassword" style="display: none;">Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.</div>
<div id="saveAndResume" style="display: none;">Save and Resume Later</div>
<div id="saveResumeProcess" style="display: none;">Save and get link</div>
<div id="fileTypeAlert" style="display:none;">You must upload one of the following file types for the selected field:</div>
<div id="embedError" style="display:none;">There was an error displaying the form. Please copy and paste the embed code again.</div>
<div id="applyDiscountButton" style="display:none;">Apply Discount</div>
<div id="dcmYouSaved" style="display:none;">You saved</div>
<div id="dcmWithCode" style="display:none;">with code</div>
<div id="submitButtonText" style="display:none;">SUBMIT</div>
<div id="submittingText" style="display:none;">Submitting</div>
<div id="validatingText" style="display:none;">Validating</div>
<div id="autocaptureDisabledText" style="display:none;"></div>
<div id="paymentInitError" style="display:none;">There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.</div>
<div id="checkFieldPrompt" style="display:none;">Please check the field: </div>
<div id="translatedWord-fields" style="display:none;">Fields</div>
<div class="fsPage" id="fsPage3510683-1">
<div id="ReactContainer3510683" style="display:none" class="FsReactContainerInitApp" data-fs-react-app-id="3510683"></div>
<div class="fsSection fs2Col" id="fsSection79606975">
<div class="fsSectionHeader">
</div>
<div id="fsRow3510683-2" class="fsRow fsFieldRow fsLastRow" style="display: none;">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell79606976" lang="en" fs-field-type="radio" fs-field-validation-name="Form Choice">
<fieldset role="group" aria-labelledby="fsLegend79606976" id="label79606976">
<legend id="fsLegend79606976" class="fsLabel fsLabelVertical"><span>Form Choice</span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel horizontal" for="field79606976_1"><input type="radio" id="field79606976_1" name="field79606976" value="Download a Free Guide" class="fsField horizontal">Download a Free Guide</label>
<label class="fsOptionLabel horizontal" for="field79606976_2"><input type="radio" id="field79606976_2" name="field79606976" value="Request An Appointment" class="fsField horizontal">Request An Appointment</label>
</div>
</fieldset>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-3" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell79606978" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<h1 style="text-align: center;">Request an Appointment</h1>
<p style="text-align: center;">Take the next step toward better health today. Please enter your contact information below and our team will respond to your appointment request as soon as possible.</p>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-4" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell160342842" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<h1 style="text-align:center;">Download Your Guide</h1>
<p style="text-align: center;">Please fill out the form below to receive your guide. We hope it provides answers and helps you take charge of your health.</p>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-5" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell79606979" lang="en" fs-field-type="text" fs-field-validation-name="First Name">
<label id="label79606979" class="fsLabel fsRequiredLabel" for="field79606979">First Name<span class="fsRequiredMarker">*</span> </label>
<input type="text" id="field79606979" name="field79606979" size="50" required="" value="" class="fsField fsFormatText fsRequired fsAutocomplete ui-autocomplete-input" aria-required="true" autocomplete="off"><span role="status"
aria-live="polite" class="ui-helper-hidden-accessible"></span>
<input type="hidden" id="field79606979_options" value="|">
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-6" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell79606980" lang="en" fs-field-type="text" fs-field-validation-name="Last Name">
<label id="label79606980" class="fsLabel fsRequiredLabel" for="field79606980">Last Name<span class="fsRequiredMarker">*</span> </label>
<input type="text" id="field79606980" name="field79606980" size="50" required="" value="" class="fsField fsFormatText fsRequired " aria-required="true">
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-7" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell79606981" lang="en" fs-field-type="email" fs-field-validation-name="Email">
<label id="label79606981" class="fsLabel fsRequiredLabel" for="field79606981">Email<span class="fsRequiredMarker">*</span> </label>
<input type="email" id="field79606981" name="field79606981" size="50" required="required" value="" class="fsField fsFormatEmail fsRequired" aria-required="true">
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-8" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell79606982" lang="en" fs-field-type="datetime" fs-field-validation-name="Date of Birth">
<fieldset role="group" aria-labelledby="fsLegend79606982" id="label79606982">
<legend id="fsLegend79606982" class="fsLabel fsRequiredLabel fsLabelVertical"><span>Date of Birth<span class="fsRequiredMarker">*</span></span></legend>
<div class="fieldset-content">
<!-- Used to pull in url for jquery -->
<span aria-hidden="true" style="display:none;" id="fsCalendar79606982ImageUrl">https://adventhealth.formstack.com/forms/images/2/calendar.png</span>
<input data-skip-validation="" data-date-format="M d, Y" type="hidden" id="field79606982Format" name="field79606982Format" value="MDY" disabled="">
<div class="hidden"><label for="field79606982M">Month</label></div>
<select id="field79606982M" name="field79606982M" class=" fsField fsRequired" aria-required="true" disabled="disabled">
<option value=""> </option>
<option value="Jan">Jan</option>
<option value="Feb">Feb</option>
<option value="Mar">Mar</option>
<option value="Apr">Apr</option>
<option value="May">May</option>
<option value="Jun">Jun</option>
<option value="Jul">Jul</option>
<option value="Aug">Aug</option>
<option value="Sep">Sep</option>
<option value="Oct">Oct</option>
<option value="Nov">Nov</option>
<option value="Dec">Dec</option>
</select>
<div class="hidden"><label for="field79606982D">Day</label></div>
<select id="field79606982D" name="field79606982D" class=" fsField fsRequired" aria-required="true" disabled="disabled">
<option value=""> </option>
<option value="01">01</option>
<option value="02">02</option>
<option value="03">03</option>
<option value="04">04</option>
<option value="05">05</option>
<option value="06">06</option>
<option value="07">07</option>
<option value="08">08</option>
<option value="09">09</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option>
<option value="25">25</option>
<option value="26">26</option>
<option value="27">27</option>
<option value="28">28</option>
<option value="29">29</option>
<option value="30">30</option>
<option value="31">31</option>
</select>
<div class="hidden"><label for="field79606982Y">Year</label></div>
<select id="field79606982Y" name="field79606982Y" class=" fsField fsRequired" aria-required="true" disabled="disabled">
<option value=""> </option>
<option value="1924">1924</option>
<option value="1925">1925</option>
<option value="1926">1926</option>
<option value="1927">1927</option>
<option value="1928">1928</option>
<option value="1929">1929</option>
<option value="1930">1930</option>
<option value="1931">1931</option>
<option value="1932">1932</option>
<option value="1933">1933</option>
<option value="1934">1934</option>
<option value="1935">1935</option>
<option value="1936">1936</option>
<option value="1937">1937</option>
<option value="1938">1938</option>
<option value="1939">1939</option>
<option value="1940">1940</option>
<option value="1941">1941</option>
<option value="1942">1942</option>
<option value="1943">1943</option>
<option value="1944">1944</option>
<option value="1945">1945</option>
<option value="1946">1946</option>
<option value="1947">1947</option>
<option value="1948">1948</option>
<option value="1949">1949</option>
<option value="1950">1950</option>
<option value="1951">1951</option>
<option value="1952">1952</option>
<option value="1953">1953</option>
<option value="1954">1954</option>
<option value="1955">1955</option>
<option value="1956">1956</option>
<option value="1957">1957</option>
<option value="1958">1958</option>
<option value="1959">1959</option>
<option value="1960">1960</option>
<option value="1961">1961</option>
<option value="1962">1962</option>
<option value="1963">1963</option>
<option value="1964">1964</option>
<option value="1965">1965</option>
<option value="1966">1966</option>
<option value="1967">1967</option>
<option value="1968">1968</option>
<option value="1969">1969</option>
<option value="1970">1970</option>
<option value="1971">1971</option>
<option value="1972">1972</option>
<option value="1973">1973</option>
<option value="1974">1974</option>
<option value="1975">1975</option>
<option value="1976">1976</option>
<option value="1977">1977</option>
<option value="1978">1978</option>
<option value="1979">1979</option>
<option value="1980">1980</option>
<option value="1981">1981</option>
<option value="1982">1982</option>
<option value="1983">1983</option>
<option value="1984">1984</option>
<option value="1985">1985</option>
<option value="1986">1986</option>
<option value="1987">1987</option>
<option value="1988">1988</option>
<option value="1989">1989</option>
<option value="1990">1990</option>
<option value="1991">1991</option>
<option value="1992">1992</option>
<option value="1993">1993</option>
<option value="1994">1994</option>
<option value="1995">1995</option>
<option value="1996">1996</option>
<option value="1997">1997</option>
<option value="1998">1998</option>
<option value="1999">1999</option>
<option value="2000">2000</option>
<option value="2001">2001</option>
<option value="2002">2002</option>
<option value="2003">2003</option>
<option value="2004">2004</option>
<option value="2005">2005</option>
<option value="2006">2006</option>
<option value="2007">2007</option>
<option value="2008">2008</option>
<option value="2009">2009</option>
<option value="2010">2010</option>
<option value="2011">2011</option>
<option value="2012">2012</option>
<option value="2013">2013</option>
<option value="2014">2014</option>
<option value="2015">2015</option>
<option value="2016">2016</option>
<option value="2017">2017</option>
<option value="2018">2018</option>
<option value="2019">2019</option>
<option value="2020">2020</option>
<option value="2021">2021</option>
<option value="2022">2022</option>
<option value="2023">2023</option>
<option value="2024">2024</option>
</select>
<input data-skip-validation="" type="text" id="fsCalendar79606982Link" class="fsCalendarPickerLink hasDatepicker" style="display:none;" aria-hidden="true" disabled="disabled"><img class="ui-datepicker-trigger"
src="https://adventhealth.formstack.com/forms/images/2/calendar.png" alt="Select Date" title="Select Date" aria-hidden="true">
<div id="fsCalendar79606982" class="fsCalendar" style=" position:absolute"></div>
</div>
</fieldset>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-9" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell79606983" lang="en" fs-field-type="phone" fs-field-validation-name="Phone">
<label id="label79606983" class="fsLabel fsRequiredLabel" for="field79606983">Phone<span class="fsRequiredMarker">*</span> </label>
<input type="tel" id="field79606983" name="field79606983" size="15" required="" value="" class="fsField fsFormatPhoneUS fsRequired" aria-required="true" disabled="disabled" data-country="US" data-format="user">
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-10" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell79606984" lang="en" fs-field-type="number" fs-field-validation-name="ZIP Code">
<label id="label79606984" class="fsLabel fsRequiredLabel" for="field79606984">ZIP Code<span class="fsRequiredMarker">*</span> </label>
<input type="number" step="any" id="field79606984" name="field79606984" required="" class="fsField fsFormatNumber fsNumberDecimals-0 fsRequired" aria-required="true">
<script nonce="">
//This script is to address some quirkiness of Safari where commas are interchangeable with decimal points on number fields.
//Normal attempts to restrict the comma such as our own validation or .replace(",", "") results in the value of the field being removed entirely.
//Below the keypress itself is being blocked as a workaround to keep our value.
document.getElementById("field79606984").addEventListener("keydown", function blockComma(e) {
if (e.code === 'Comma') {
e.preventDefault();
}
})
</script>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-11" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell79606985" lang="en" fs-field-type="textarea" fs-field-validation-name="Comments">
<label id="label79606985" class="fsLabel" for="field79606985">Comments </label>
<textarea id="field79606985" class="fsField " name="field79606985" rows="10" cols="50" disabled="disabled"></textarea>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-12" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell79606986" lang="en" fs-field-type="checkbox" fs-field-validation-name="Let's Keep In Touch">
<fieldset role="group" aria-labelledby="fsLegend79606986" id="label79606986">
<legend id="fsLegend79606986" class="fsLabel fsLabelVertical"><span>Let's Keep In Touch</span></legend>
<div class="fieldset-content">
<label class="fsOptionLabel vertical" for="field79606986_1"><input type="checkbox" id="field79606986_1" name="field79606986[]"
value="Yes, I want AdventHealth to send me information about its various services via phone, email or direct mail." class="fsField vertical">Yes, I want AdventHealth to send me information about its various services via phone, email
or direct mail.</label>
</div>
</fieldset>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-13" class="fsRow fsFieldRow fsLastRow">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsSpan100" id="fsCell79606987" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<p style="text-align: center;"><span style="text-align: center; font-color:#666666; font-size:12px;">If you are having a medical emergency, please call 911.</span></p>
</div>
<div class="fs-clear"></div>
</div>
<div id="fsRow3510683-14" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100" id="fsCell79606988" lang="en" fs-field-type="richtext" fs-field-validation-name="">
<p style="text-align: center;"><span style="text-align: center; font-color:#666666; font-size:12px;">By submitting this form, I agree to receive communications from AdventHealth. </span></p>
</div>
<div class="fs-clear"></div>
</div>
</div>
<div class="fsSection fs1Col" id="fsSection79606989">
<div class="fsSectionHeader">
</div>
<div id="fsRow3510683-16" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell142754473" aria-describedby="fsSupporting142754473" lang="en" fs-field-type="text" fs-field-validation-name="LSP Id">
<label id="label142754473" class="fsLabel" for="field142754473">LSP Id </label>
<input type="text" id="field142754473" name="field142754473" size="50" value="a2G2M00000Md6V6" class="fsField fsFormatText ">
<div id="fsSupporting142754473" class="fsSupporting">Case: Add_to_f9list_id</div>
</div>
</div>
<div id="fsRow3510683-17" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606990" aria-describedby="fsSupporting79606990" lang="en" fs-field-type="text"
fs-field-validation-name="Area of Interest">
<label id="label79606990" class="fsLabel" for="field79606990">Area of Interest </label>
<input type="text" id="field79606990" name="field79606990" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79606990" class="fsSupporting">Area of Interest - Area_of_Interest__c - Case</div>
</div>
</div>
<div id="fsRow3510683-18" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606991" aria-describedby="fsSupporting79606991" lang="en" fs-field-type="text"
fs-field-validation-name="Service Line">
<label id="label79606991" class="fsLabel" for="field79606991">Service Line </label>
<input type="text" id="field79606991" name="field79606991" size="50" value="Orthopedics" class="fsField fsFormatText ">
<div id="fsSupporting79606991" class="fsSupporting">Service Line - ServiceLine__c - Case</div>
</div>
</div>
<div id="fsRow3510683-19" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606992" aria-describedby="fsSupporting79606992" lang="en" fs-field-type="text" fs-field-validation-name="Subject">
<label id="label79606992" class="fsLabel" for="field79606992">Subject </label>
<input type="text" id="field79606992" name="field79606992" size="50" value="Ortho_General_FL_CN_18 form submission" class="fsField fsFormatText ">
<div id="fsSupporting79606992" class="fsSupporting">Subject - Subject - Case</div>
</div>
</div>
<div id="fsRow3510683-20" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606993" aria-describedby="fsSupporting79606993" lang="en" fs-field-type="text"
fs-field-validation-name="Case Status">
<label id="label79606993" class="fsLabel" for="field79606993">Case Status </label>
<input type="text" id="field79606993" name="field79606993" size="50" value="Open" class="fsField fsFormatText fsAutocomplete ui-autocomplete-input" autocomplete="off"><span role="status" aria-live="polite"
class="ui-helper-hidden-accessible"></span>
<input type="hidden" id="field79606993_options" value="Open|">
<div id="fsSupporting79606993" class="fsSupporting">Status - Status - Case</div>
</div>
</div>
<div id="fsRow3510683-21" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606994" aria-describedby="fsSupporting79606994" lang="en" fs-field-type="text"
fs-field-validation-name="Campus Submitted">
<label id="label79606994" class="fsLabel" for="field79606994">Campus Submitted </label>
<input type="text" id="field79606994" name="field79606994" size="50" value="AdventHealth Central Florida North" class="fsField fsFormatText ">
<div id="fsSupporting79606994" class="fsSupporting">Campus Submitted - Campus_Submitted__c - Case</div>
</div>
</div>
<div id="fsRow3510683-22" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606995" aria-describedby="fsSupporting79606995" lang="en" fs-field-type="text"
fs-field-validation-name="Case Origin">
<label id="label79606995" class="fsLabel" for="field79606995">Case Origin </label>
<input type="text" id="field79606995" name="field79606995" size="50" value="Web" class="fsField fsFormatText ">
<div id="fsSupporting79606995" class="fsSupporting">Case Origin - Origin - Case</div>
</div>
</div>
<div id="fsRow3510683-23" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606996" aria-describedby="fsSupporting79606996" lang="en" fs-field-type="text" fs-field-validation-name="Line">
<label id="label79606996" class="fsLabel" for="field79606996">Line </label>
<input type="text" id="field79606996" name="field79606996" size="50" value="Web Lead" class="fsField fsFormatText fsAutocomplete ui-autocomplete-input" autocomplete="off"><span role="status" aria-live="polite"
class="ui-helper-hidden-accessible"></span>
<input type="hidden" id="field79606996_options" value="|">
<div id="fsSupporting79606996" class="fsSupporting">Line - Line__c - Case</div>
</div>
</div>
<div id="fsRow3510683-24" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606997" aria-describedby="fsSupporting79606997" lang="en" fs-field-type="text"
fs-field-validation-name="Referral Path">
<label id="label79606997" class="fsLabel" for="field79606997">Referral Path </label>
<input type="text" id="field79606997" name="field79606997" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79606997" class="fsSupporting">ReferralPath - ReferralPath__c - Case</div>
</div>
</div>
<div id="fsRow3510683-25" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606998" aria-describedby="fsSupporting79606998" lang="en" fs-field-type="text"
fs-field-validation-name="Referral Value">
<label id="label79606998" class="fsLabel" for="field79606998">Referral Value </label>
<input type="text" id="field79606998" name="field79606998" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79606998" class="fsSupporting">ReferralValue - ReferralValue__c - Case</div>
</div>
</div>
<div id="fsRow3510683-26" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79606999" aria-describedby="fsSupporting79606999" lang="en" fs-field-type="text"
fs-field-validation-name="Referral Source">
<label id="label79606999" class="fsLabel" for="field79606999">Referral Source </label>
<input type="text" id="field79606999" name="field79606999" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79606999" class="fsSupporting">Referral Source - Referral_Source__c - Campaign</div>
</div>
</div>
<div id="fsRow3510683-27" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607000" aria-describedby="fsSupporting79607000" lang="en" fs-field-type="text" fs-field-validation-name="Campaign">
<label id="label79607000" class="fsLabel" for="field79607000">Campaign </label>
<input type="text" id="field79607000" name="field79607000" size="50" value="701410000013RTkAAM" class="fsField fsFormatText ">
<div id="fsSupporting79607000" class="fsSupporting">Campaign - Campaign__c - Case</div>
</div>
</div>
<div id="fsRow3510683-28" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607001" lang="en" fs-field-type="text" fs-field-validation-name="Campaign Channel">
<label id="label79607001" class="fsLabel" for="field79607001">Campaign Channel </label>
<input type="text" id="field79607001" name="field79607001" size="50" value="" class="fsField fsFormatText ">
</div>
</div>
<div id="fsRow3510683-29" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607002" aria-describedby="fsSupporting79607002" lang="en" fs-field-type="text"
fs-field-validation-name="Campaign Response">
<label id="label79607002" class="fsLabel" for="field79607002">Campaign Response </label>
<input type="text" id="field79607002" name="field79607002" size="50" value=" Responded" class="fsField fsFormatText fsAutocomplete ui-autocomplete-input" autocomplete="off"><span role="status" aria-live="polite"
class="ui-helper-hidden-accessible"></span>
<input type="hidden" id="field79607002_options" value="|">
<div id="fsSupporting79607002" class="fsSupporting">Status - Status - CampaignMember</div>
</div>
</div>
<div id="fsRow3510683-30" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607003" aria-describedby="fsSupporting79607003" lang="en" fs-field-type="text"
fs-field-validation-name="Lead Source">
<label id="label79607003" class="fsLabel" for="field79607003">Lead Source </label>
<input type="text" id="field79607003" name="field79607003" size="50" value="Web Form: Ortho_General_FL_CN_18" class="fsField fsFormatText ">
<div id="fsSupporting79607003" class="fsSupporting">Lead Source - LeadSource - Contact</div>
</div>
</div>
<div id="fsRow3510683-31" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607004" aria-describedby="fsSupporting79607004" lang="en" fs-field-type="text"
fs-field-validation-name="Opt In Email Description">
<label id="label79607004" class="fsLabel" for="field79607004">Opt In Email Description </label>
<input type="text" id="field79607004" name="field79607004" size="50" value="Web Form: Ortho_General_FL_CN_18" class="fsField fsFormatText ">
<div id="fsSupporting79607004" class="fsSupporting">Email Opt In Description - Email_Opt_In_Description__c - Contact</div>
</div>
</div>
<div id="fsRow3510683-32" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell142754494" aria-describedby="fsSupporting142754494" lang="en" fs-field-type="radio"
fs-field-validation-name="Formstack Submission">
<fieldset role="group" aria-labelledby="fsLegend142754494" id="label142754494">
<legend id="fsLegend142754494" class="fsLabel fsLabelVertical"><span>Formstack Submission</span></legend>
<div class="fieldset-content fsHiddenByFieldSetting">
<label class="fsOptionLabel vertical" for="field142754494_1"><input type="radio" id="field142754494_1" name="field142754494" value="True" checked="checked" class="fsField vertical">True</label>
<div id="fsSupporting142754494" class="fsSupporting">Case: Formstack_Submission__c</div>
</div>
</fieldset>
</div>
</div>
<div id="fsRow3510683-33" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607005" aria-describedby="fsSupporting79607005" lang="en" fs-field-type="text"
fs-field-validation-name="Campaign Name">
<label id="label79607005" class="fsLabel" for="field79607005">Campaign Name </label>
<input type="text" id="field79607005" name="field79607005" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607005" class="fsSupporting">This hidden field has been added by Attribution to CRM Plugin to store Campaign Name in this Form's submission table</div>
</div>
</div>
<div id="fsRow3510683-34" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607006" aria-describedby="fsSupporting79607006" lang="en" fs-field-type="text"
fs-field-validation-name="Campaign Source">
<label id="label79607006" class="fsLabel" for="field79607006">Campaign Source </label>
<input type="text" id="field79607006" name="field79607006" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607006" class="fsSupporting">This hidden field has been added by Attribution to CRM Plugin to store Campaign Source in this Form's submission table</div>
</div>
</div>
<div id="fsRow3510683-35" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607007" aria-describedby="fsSupporting79607007" lang="en" fs-field-type="text"
fs-field-validation-name="Campaign Content">
<label id="label79607007" class="fsLabel" for="field79607007">Campaign Content </label>
<input type="text" id="field79607007" name="field79607007" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607007" class="fsSupporting">This hidden field has been added by Attribution to CRM Plugin to store Campaign Content in this Form's submission table</div>
</div>
</div>
<div id="fsRow3510683-36" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607008" aria-describedby="fsSupporting79607008" lang="en" fs-field-type="text"
fs-field-validation-name="Campaign Medium">
<label id="label79607008" class="fsLabel" for="field79607008">Campaign Medium </label>
<input type="text" id="field79607008" name="field79607008" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607008" class="fsSupporting">This hidden field has been added by Attribution to CRM Plugin to store Campaign Medium in this Form's submission table</div>
</div>
</div>
<div id="fsRow3510683-37" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607009" aria-describedby="fsSupporting79607009" lang="en" fs-field-type="text"
fs-field-validation-name="Campaign Term">
<label id="label79607009" class="fsLabel" for="field79607009">Campaign Term </label>
<input type="text" id="field79607009" name="field79607009" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607009" class="fsSupporting">This hidden field has been added by Attribution to CRM Plugin to store Campaign Term in this Form's submission table</div>
</div>
</div>
<div id="fsRow3510683-38" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607010" aria-describedby="fsSupporting79607010" lang="en" fs-field-type="text"
fs-field-validation-name="Requested Physician Name">
<label id="label79607010" class="fsLabel" for="field79607010">Requested Physician Name </label>
<input type="text" id="field79607010" name="field79607010" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607010" class="fsSupporting">Preferred Physician - Requested_Physician_Name__c - Case</div>
</div>
</div>
<div id="fsRow3510683-39" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607013" aria-describedby="fsSupporting79607013" lang="en" fs-field-type="text"
fs-field-validation-name="Guide Choice">
<label id="label79607013" class="fsLabel" for="field79607013">Guide Choice </label>
<input type="text" id="field79607013" name="field79607013" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607013" class="fsSupporting">Guide Choice - Guide_Choice__c - Case</div>
</div>
</div>
<div id="fsRow3510683-40" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell79607014" aria-describedby="fsSupporting79607014" lang="en" fs-field-type="text" fs-field-validation-name="HRA">
<label id="label79607014" class="fsLabel" for="field79607014">HRA </label>
<input type="text" id="field79607014" name="field79607014" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting79607014" class="fsSupporting">HRA - HRA__c - Case</div>
</div>
</div>
<div id="fsRow3510683-41" class="fsRow fsFieldRow fsLastRow fsHidden">
<div class="fsRowBody fsCell fsFieldCell fsFirst fsLast fsLabelVertical fsHidden fsSpan100 fsHiddenByFieldSetting" id="fsCell133200577" aria-describedby="fsSupporting133200577" lang="en" fs-field-type="text"
fs-field-validation-name="GCLID (Google Click Identifier)">
<label id="label133200577" class="fsLabel" for="field133200577">GCLID (Google Click Identifier) </label>
<input type="text" id="field133200577" name="field133200577" size="50" value="" class="fsField fsFormatText ">
<div id="fsSupporting133200577" class="fsSupporting">This hidden field has been added by Attribution to CRM Plugin to store GCLID (Google Click Identifier) in this Form's submission table</div>
</div>
</div>
</div>
</div>
<div id="fsSubmit3510683" class="fsSubmit fsPagination">
<button type="button" id="fsPreviousButton3510683" class="fsPreviousButton" value="Previous Page" style="display:none;" aria-label="Previous"><span class="fsFull">Previous</span><span class="fsSlim">←</span></button>
<button type="button" id="fsNextButton3510683" class="fsNextButton" value="Next Page" style="display:none;" aria-label="Next"><span class="fsFull">Next</span><span class="fsSlim">→</span></button>
<input id="fsSubmitButton3510683" class="fsSubmitButton" style="" type="submit" value="SUBMIT">
<div class="clear"></div>
<div class="">
</div>
</div>
<script type="text/javascript" nonce="">
window.FS_FIELD_DATA_3510683 = [];
</script>
<script type="text/javascript" src="//static.formstack.com/forms/js/3/jquery-ui.min_42a497cb9f.js" nonce=""></script>
<script type="text/javascript" src="//static.formstack.com/forms/js/3/scripts_5c7975ec6c.js" nonce=""></script>
<script type="text/javascript" src="//static.formstack.com/forms/js/3/analytics_7d49daa365.js" nonce=""></script>
<script type="text/javascript" src="//static.formstack.com/forms/js/3/libphonenumber-min_febdd85580.js" nonce=""></script>
<script type="text/javascript" src="//static.formstack.com/forms/js/3/plugins/utm_tracking_38238fc4e1.js" nonce=""></script>
<script type="text/javascript" src="//static.formstack.com/forms/js/3/modernizr_60a2d5aeb5.js" nonce=""></script>
<script type="text/javascript" nonce="">
(function() {
var isLocalStorageSafe = true;
try {
if (typeof sessionStorage !== 'undefined' && sessionStorage.fsFonts) {
document.documentElement.className = document.documentElement.className += ' wf-active';
}
} catch (e) {
console.log('Failed to read from localStorage', e.message);
isLocalStorageSafe = false;
}
var pre = document.createElement('link');
pre.rel = 'preconnect';
pre.href = 'https://fonts.googleapis.com/';
pre.setAttribute('crossorigin', '');
var s = document.getElementsByTagName('head')[0];
s.appendChild(pre);
var fontConfig = {
google: {
families: ['Montserrat:400,700']
},
timeout: 2000,
active: function() {
if (!isLocalStorageSafe || typeof sessionStorage === 'undefined') {
return;
}
sessionStorage.fsFonts = true;
}
};
if (typeof WebFont === 'undefined') {
window.WebFontConfig = fontConfig;
var wf = document.createElement('script');
wf.type = 'text/javascript';
wf.async = 'true';
wf.src = ('https:' == document.location.protocol ? 'https' : 'http') + '://ajax.googleapis.com/ajax/libs/webfont/1/webfont.js';
s.appendChild(wf);
} else {
WebFont.load(fontConfig);
}
})();
if (window.addEventListener) {
window.addEventListener('load', loadFormstack, false);
} else if (window.attachEvent) {
window.attachEvent('onload', loadFormstack);
} else {
loadFormstack();
}
function loadFormstack() {
var form3510683 = new Formstack.Form(3510683, 'https://adventhealth.formstack.com/forms/');
form3510683.checks.push({
target: '79606978',
action: 'Show',
bool: 'OR',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '==',
option: 'Request An Appointment'
}]
});
form3510683.checks.push({
target: '160342842',
action: 'Show',
bool: 'AND',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '==',
option: 'Download a Free Guide'
}]
});
form3510683.checks.push({
target: '79606982',
action: 'Show',
bool: 'AND',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '==',
option: 'Request An Appointment'
}]
});
form3510683.checks.push({
target: '79606983',
action: 'Show',
bool: 'AND',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '==',
option: 'Request An Appointment'
}]
});
form3510683.checks.push({
target: '79606985',
action: 'Show',
bool: 'AND',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '==',
option: 'Request An Appointment'
}]
});
form3510683.checks.push({
target: '79606986',
action: 'Show',
bool: 'AND',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '!=',
option: 'Download a Free Guide'
}]
});
form3510683.checks.push({
target: '79606987',
action: 'Show',
bool: 'AND',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '!=',
option: 'Download a Free Guide'
}]
});
form3510683.checks.push({
target: '79606988',
action: 'Show',
bool: 'AND',
fields: ['79606976'],
checks: [{
field: '79606976',
condition: '==',
option: 'Download a Free Guide'
}]
});
form3510683.logicFields = ['79606976'];
form3510683.calcFields = [];
form3510683.dateCalcFields = [];
form3510683.init();
if (Formstack.Analytics) {
form3510683.plugins.analytics = new Formstack.Analytics('https://adventhealth.formstack.com', 3510683, form3510683);
form3510683.plugins.analytics.trackTouch();
form3510683.plugins.analytics.trackBottleneck();
}
form3510683.plugins.utmTracking = new Formstack.UTMTracking({
"source": 79607006,
"medium": 79607008,
"term": 79607009,
"content": 79607007,
"name": 79607005,
"gclid": 133200577
}, "https://adventhealth.formstack.com");
window.form3510683 = form3510683;
};
</script>
<input name="fsUserAgent" id="fsUserAgent" type="hidden" value="Mozilla/5.0 (Windows NT 10.0; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/126.0.0.0 Safari/537.36">
</form>
Text Content
AdventHealth The information on this website is not a substitute for examination, diagnosis, and medical care provided by a licensed and qualified health professional. Please talk to your doctor before starting any form of medical treatment and/or adopting any exercise program or dietary guidelines. If this is a medical emergency, please call 911 immediately. AdventHealth reserves the right to add, remove, or edit content from this page at its sole discretion. Privacy Policy. START YOUR JOURNEY TO WHOLE HEALTH TODAY Or call us at 866-593-2692. REGAIN YOUR MOBILITY, REGAIN YOUR LIFE Feel confident receiving care that’s earned Orthopedic Center of Excellence designations for spine surgery, total shoulder, total knee and total hip replacement. Double-click to edit this text Double-click to edit this text Listen as the bariatric staff, Dr. Kim and Dr. Smith of The Center for Metabolic and Obesity Surgery, share their passion for making a difference in the lives of our patients at Florida Hospital. The personal support you need is here, no matter when you need it. At your initial diagnosis, you’ll be assigned a designated digestive care coordinator who will be with you all the way through each stage of the recovery process. Your coordinator will be available to answer any questions about scheduling, treatment, therapy, and whatever else may come to mind. It’s all simply to make your life easier. PUTTING YOU FIRST FROM THE START Our expert surgeons and nurses are nationally acclaimed thought-leaders dedicated to improving the level of digestive care for our patients BEST REGIONAL HOSPITAL Florida Hospital is recognized by U.S. News & World Report as one of America’s best hospitals. Request an AppointmentCall 866-593-2692SIGN UP @ CALL 407-630-8355Call 866-593-2692Request an Appointment NATIONALLY RECOGNIZED FOR PATIENT SAFETY Florida Hospital is recognized as one of America’s highest-rated hospitals for patient safety by The Leapfrog Group. Request an Appointment If you’ve suffered an orthopedic injury or have been experiencing pain, weakness or instability in your joints, we want to set you on a path to recovery. With convenient hospital locations and orthopedic specialists all over the Central Florida area, help may be even closer than you think. Request an Appointment ON A MISSION TO ADVANCE BARIATRIC CARE SETTING A NEW STANDARD FOR SETTING A NEW STANDARD FOR STAY INFORMED. BE CONNECTED. Sign up for updates on the latest news, information and events throughout AdventHealth’s Network of Care. SIGN UP NOW AdventHealth keeps our Central Florida community moving by treating orthopedic issues with some of the most advanced techniques and treatments available. Whether you’ve experienced a recent injury or are feeling more limited than ever by arthritis, we’ll work together toward your recovery goals. Since your needs are unique, a multidisciplinary team of specialists will customize your comprehensive care plan using a whole-person approach. With same-week appointments typically available, we’ll help you get back to feeling like yourself again as soon as possible. CHRONIC PAIN? FIND RELIEF We’ve been recognized for our efforts to stay on the leading-edge of orthopedic treatments, as well as for our high standard of patient care. OUR BIGGEST ACHIEVEMENT IS CARING FOR YOU JOINT COMMISSION GOLD SEAL OF APPROVAL AdventHealth is accredited and certified across 13 locations in the Volusia and Flagler region, earning the Joint Commission Gold Seal of Approval for Orthopedic Surgery. We're here for you at every age and stage of your health and wellness journey. YOUR COMPLETE NETWORK OF CARE AdventHealth Fish Memorial 1055 Saxon Boulevard, Orange City, FL 32763 Directions AdventHealth DeLand 701 West Plymouth Avenue, DeLand, FL 32720 Directions AdventHealth Palm Coast 60 Memorial Medical Parkway, Palm Coast, FL 32164 Directions AdventHealth Daytona Beach 301 Memorial Medical Parkway, Daytona Beach, FL 32117 Directions AdventHealth New Smyrna Beach 401 Palmetto Street, New Smyrna, FL 32168 Directions ADVENTHEALTH PORT ORANGE HEALTH PARK 5821 S Williamson Boulevard Port Orange, FL 32128 * Directions ADVENTHEALTH MEDICAL PLAZA PALM COAST 120 Cypress Edge Drive Palm Coast, FL 32164 * Directions ADVENTHEALTH DELAND 701 West Plymouth Avenue, DeLand, FL 32720 * Directions ADVENTHEALTH FISH MEMORIAL 1055 Saxon Boulevard, Orange City, FL 32763 * Directions ADVENTHEALTH PALM COAST 60 Memorial Medical Parkway, Palm Coast, FL 32164 * Directions ADVENTHEALTH DAYTONA BEACH 301 Memorial Medical Parkway, Daytona Beach, FL 32117 * Directions ADVENTHEALTH NEW SMYRNA BEACH 401 Palmetto Street, New Smyrna, FL 32168 * Directions ADVENTHEALTH WATERMAN 1000 Waterman Way, Tavares, FL 32778 * Directions ADVENTHEALTH PORT ORANGE HEALTH PARK 5821 S Williamson Boulevard Port Orange, FL 32128 * Directions ADVENTHEALTH MEDICAL PLAZA PALM COAST 120 Cypress Edge Drive Palm Coast, FL 32164 * Directions ADVENTHEALTH DELAND 701 West Plymouth Avenue, DeLand, FL 32720 * Directions ADVENTHEALTH FISH MEMORIAL 1055 Saxon Boulevard, Orange City, FL 32763 * Directions ADVENTHEALTH PALM COAST 60 Memorial Medical Parkway, Palm Coast, FL 32164 * Directions ADVENTHEALTH DAYTONA BEACH 301 Memorial Medical Parkway, Daytona Beach, FL 32117 * Directions ADVENTHEALTH NEW SMYRNA BEACH 401 Palmetto Street, New Smyrna, FL 32168 * Directions ADVENTHEALTH WATERMAN 1000 Waterman Way, Tavares, FL 32778 * Directions Shoulder & Elbow Learn More Hip Treatments Learn MoreLearn More Knee Treatments EXPERTISE IN COMMON JOINT PROBLEMS Although our orthopedic team can care for every joint in your body, our experts specialize in treating shoulders and elbows, hands and wrists, hips, spines and knees with leading-edge technology and treatment plans that work for you. Learn more about our holistic approach to these specific areas: Double-click to edit this text ADVANCED PROCEDURES DESIGNED FOR YOU Our team of orthopedic specialists provides a wide range of expert treatments and care beyond just the basic orthopedic care, including: * Anterior Cruciate Ligament (ACL) Reconstruction * Arthritis and Total Joint Surgery * Foot and Ankle Surgery * Fracture Care Surgery * Hand Surgery * Ligament Repair * Meniscus Repair Surgery * Minimally Invasive and Robotic Joint Resurfacing and Replacement * Physical Therapy and Rehabilitation * Reconstruction and General Orthopedic Surgery * Revision Joint Replacement * Shoulder and Elbow Surgery * Spine Surgery * Total Joint Replacement Shoulder and Elbow Treatments Learn More Hip Treatments Learn MoreLearn More Hand Treatments EXPERTISE IN COMMON JOINT PROBLEMS Our orthopedic team can care for every joint in your body with leading-edge technology and treatment plans that work for you. Learn more about our holistic approach in these specific areas. Spine Treatments Learn MoreLearn More Knee Treatments USING ADVANCED ROBOTICS FOR YOUR FASTER RECOVERY At our campuses, our skilled surgeons use state-of-the-art robotics, including the Mako™ robotic-arm assisted surgery system, to streamline your procedure and help you feel better faster. Through robotic technology like Mako™, we can significantly reduce your pain, scarring and recovery time, as compared to traditional surgery. With this technology, a 3D model of your joint is created and assists your surgeon during your procedure. Robotic surgery empowers surgeons and patients through: * More precise resurfacing of only the arthritic portion of the joint * Preservation of healthy joint tissue and bone * Facilitation of optimal implant positioning, resulting in a more natural-feeling joint * Quicker recovery and a shorter hospital stay Our physicians are here to talk through your surgery options with you to determine if you could benefit from robot-assisted procedures for your joints. Foot and Ankle Treatments Learn More TURN TO US FOR FOOT AND ANKLE CARE You can count on our orthopedic team for expert foot and ankle care to mend broken bones and torn tendons and ligaments. From simple solutions like bracing and strapping for minor aches and pains to corrective and reconstructive surgery that helps relieve chronic issues, we’ll tend to your needs at every step. Our team will work one-on-one with you to understand your symptoms and discuss the best treatment options to get you back on your feet. Sports Medicine Learn More BLUE DISTINCTION® CENTER FOR KNEE AND HIP REPLACEMENT AdventHealth Palm Coast, Deland, New Smyrna Beach, Fish Memorial and Daytona Beach are recognized as Blue Distinction Centers for Hip and Knee Replacements by the Blue Cross Blue Shield Association for providing safe, effective surgical care and delivering better outcomes for the community. BLUE DISTINCTION® CENTER+ FOR KNEE AND HIP CARE AdventHealth Waterman is designated as a Blue Distinction Center+ for Hip and Knee services addressing consumers' need for affordable health care. AdventHealth Port Orange Health Park 5821 S Williamson Boulevard, Port Orange, FL 32128 Directions AdventHealth Medical Plaza Palm Coast 120 Cypress Edge Drive, Palm Coast, FL 32164 Directions AdventHealth Waterman 1000 Waterman Way, Tavares, FL 32778 Directions Please fill in a valid value for all required fields Please ensure all values are in a proper format. Are you sure you want to leave this form and resume later? Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form. Save and Resume Later Save and get link You must upload one of the following file types for the selected field: There was an error displaying the form. Please copy and paste the embed code again. Apply Discount You saved with code SUBMIT Submitting Validating There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue. Please check the field: Fields Form Choice Download a Free Guide Request An Appointment REQUEST AN APPOINTMENT Take the next step toward better health today. Please enter your contact information below and our team will respond to your appointment request as soon as possible. DOWNLOAD YOUR GUIDE Please fill out the form below to receive your guide. We hope it provides answers and helps you take charge of your health. First Name* Last Name* Email* Date of Birth* https://adventhealth.formstack.com/forms/images/2/calendar.png Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 Phone* ZIP Code* Comments Let's Keep In Touch Yes, I want AdventHealth to send me information about its various services via phone, email or direct mail. If you are having a medical emergency, please call 911. By submitting this form, I agree to receive communications from AdventHealth. LSP Id Case: Add_to_f9list_id Area of Interest Area of Interest - Area_of_Interest__c - Case Service Line Service Line - ServiceLine__c - Case Subject Subject - Subject - Case Case Status Status - Status - Case Campus Submitted Campus Submitted - Campus_Submitted__c - Case Case Origin Case Origin - Origin - Case Line Line - Line__c - Case Referral Path ReferralPath - ReferralPath__c - Case Referral Value ReferralValue - ReferralValue__c - Case Referral Source Referral Source - Referral_Source__c - Campaign Campaign Campaign - Campaign__c - Case Campaign Channel Campaign Response Status - Status - CampaignMember Lead Source Lead Source - LeadSource - Contact Opt In Email Description Email Opt In Description - Email_Opt_In_Description__c - Contact Formstack Submission True Case: Formstack_Submission__c Campaign Name This hidden field has been added by Attribution to CRM Plugin to store Campaign Name in this Form's submission table Campaign Source This hidden field has been added by Attribution to CRM Plugin to store Campaign Source in this Form's submission table Campaign Content This hidden field has been added by Attribution to CRM Plugin to store Campaign Content in this Form's submission table Campaign Medium This hidden field has been added by Attribution to CRM Plugin to store Campaign Medium in this Form's submission table Campaign Term This hidden field has been added by Attribution to CRM Plugin to store Campaign Term in this Form's submission table Requested Physician Name Preferred Physician - Requested_Physician_Name__c - Case Guide Choice Guide Choice - Guide_Choice__c - Case HRA HRA - HRA__c - Case GCLID (Google Click Identifier) This hidden field has been added by Attribution to CRM Plugin to store GCLID (Google Click Identifier) in this Form's submission table Previous← Next→ Enter your save and resume password Cancel Confirm Online Form - Ortho_General_FL_CN_18 THANK YOU. Thank you for taking the next step with AdventHealth. Our Nurse Navigators have received your request and will reply to your appointment request within 48 hours.