Skip to content

Orthopedic & Spine Institute at St. Mary's Medical Center

Search the site for:

Facebook
Twitter
Instagram
YouTube

Schedule an Appointment
Select Language
Refer a Patient

Orthopedic Conditions
- Centers of Excellence
- Limb Lengthening
- Spinal Deformity
- Pediatric Orthopedics
- Foot & Ankle Deformity
- Hip Pain
- Joint Health
- Cartilage Repair
- Physical & Occupational Therapy
- MHE
- Stature Lengthening
- Clubfoot Center
- Orthopedic Conditions Look up a Disease/Condition Browse by Letter
  - A
  - B
  - C
  - D
  - E
  - F
  - G
  - H
  - J
  - K
  - L
  - M
  - N
  - O
  - P
  - R
  - S
  - T
  - U
  - V
  - W
  Search for a Disease/Condition
Meet the Team
Patient Stories
World Class Care
Patient Resources
About the Institute

Schedule an Appointment

Content Area

Thank you for your interest in the Paley Orthopedic & Spine Institute!

Please complete this form and the Paley Institute will respond to schedule you an appointment.

You can also request an appointment by calling our office at 561.844.5255.

Contact Information
First Name* * Required
Last Name* * Required
Parent/Guardian Name
Telephone Number* * Required
Patient Age
E-mail Address* * Required
Preferred Method of Contact* * Required
- Phone
- E-mail
Status* * Required
- Existing Patient
- New Patient
What physician are you requesting? (PLEASE CHOOSE ONE FROM LIST)* * Required
- Dr. Paley
- Dr. Feldman
- Dr. Robbins
- Dr. Lamm
- Dr. Minas
- Dr. Shannon
- Dr. Shufflebarger
- Dr. Cantor
- Dr. Asghar
- Dr. Giufrida
- Dr. Huser
- Dr. Dobbs
- Dr. Quinnan
- I'm Not Certain
Home/Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
How did you hear about the Paley Institute?
Name of Physician that referred you
Medical Information
Diagnosis/Chief Complaint* * Required
Have you had previous surgery?* * Required
- Yes
- No
Please describe your previous surgical procedures
File Uploads
Upload X-rays, MRIs, CT scans, etc, if available
Drop files here or
Additional Files
Drop files here or
Your Insurer* * Required
Other Insurer

901 45th Street
Kimmel Building
West Palm Beach, FL 33407

561-844-5255
Fax 561-844-5245

©2018 paleyinstitute.org

Get in Touch

First Name* * Required
Last Name* * Required
Phone* * Required
E-mail* * Required
Status * Required
- Existing Patient
- New Patient
What Physician are you requesting?* * Required
Diagnosis/Chief Complaint

Facebook
Twitter
Instagram
YouTube

Home
Privacy Policy
Terms & Conditions
HIPAA Notice of Privacy Practices
For Employee Links

PDF files require Adobe Reader.

Chat with usLiveChat

GDPR & CCPA Notice: Cookies are sometimes added to make this site work properly, we place small data files called cookies on your device. Most big websites do this too.

We won't collect any data if you select decline

Accept

Decline