Information for New Patients...
If you are a new patient and would like to get a head-start on your road to treatment and recovery, here are some forms
that you can fill out and bring with you to your first appointment.
We accept most forms of insurance and will help you thru the claim-filing process. MasterCard, Visa, Discover, and American Express are also
accepted.
Forms
Confidential Patient Information
Contains general information about you. This will be kept in your confidential medical
file. Please see our Privacy Act for more information about how we handle confidential information.
[ Download PDF ]
Pain and Injury Form
This document helps you to communicate to us the extent and severity of your injury or
condition.
[ Download PDF ]
Consent to Treat a Minor
If your child will be visiting our office for consultation or treatment, please fill
out this release.
[ Download PDF ]
Medical Information Release
This document authorizes other medical providers (e.g. your primary care physician) to
release medical records and information to us that relate to your consultation and treatment. Complies with the Confidentiality
of Medical Information Act of 1981, Section 56 et, seq., California Civil Code.
[ Download PDF ]
Privacy Policy
Acknowledgement and Consent of Privacy Practices Act.
[ Download PDF ]
Office Policy
This document outlines our office administrative policies.
[ Download PDF ]