5 Convenient
Locations
Jacksonville Mandarin
904-886-4558
3007 Hartley Rd.
Jacksonville, FL 32257 | Map
Jacksonville Southpoint
904-737-6733
4181 Southpoint Dr. E. Ste. 200
Jacksonville, FL 32216 | Map
Jacksonville St. Johns Bluff Rd
904-724-5020
2511 St. Johns Bluff Rd. S. #207
Jacksonville, FL 32246 | Map
Jacksonville Orange Park
904-276-0200
1825 Kingsley Ave. #140
Orange Park, FL 32073 | Map
Ponte Vedra Beach
904-280-4006
115 Professional Dr. #105
Ponte Vedra Beach, FL 32082 | Map

Dr. Thomas R. Farrell IV practices at our Southpoint office in Jacksonville, FL

Thomas R. Farrell IV, D.D.S
4181 Southpoint Dr. E. Ste. 200
Jacksonville, FL 32216
904-737-6733
904-731-5788 (Fax)

Jacksonville – Southpoint Dr.Hartley

Patient Registration

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. 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.

Please use Firefox or Edge browser to complete your form, a recent Chrome update is causing issues with submission.

Doctor Online Referral Form

You may refer patients to our office by filling out our secure online Referral Form. After you have completed the form, please make sure to press the Submit button at the bottom to automatically send us your information. The security and privacy of patient data is one of our primary concerns and we have taken every precaution to protect it.

Please use Firefox or Edge browser to complete your form, a recent Chrome update is causing issues with submission.

Do not fill out the patient intake form
unless you have an appointment scheduled.

Continue to the form

Do not fill out the patient intake form
unless you have an appointment scheduled.

Continue to the form

Do not fill out the patient intake form
unless you have an appointment scheduled.

Continue to the form

Do not fill out the patient intake form
unless you have an appointment scheduled.

Continue to the form

Do not fill out the patient intake form
unless you have an appointment scheduled.

Continue to the form
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