New Patients

INFORMATION FOR NEW PATIENTS:

For new patients, please print the new Patient Intake Form (adult or child) listed below.  Please complete the form and bring it with you to the first visit.  If you are unable to print out the form, please come to the office 15 minutes prior to your scheduled appointment to complete the forms in the office.  Thank you.

Please wear comfortable, loose-fitting clothing.

We are an approved provider for nearly all insurance plans.  We are happy to electronically bill your office visit to the insurance company, however we do not confirm insurance coverage or benefits.  For this reason, we recommend patients contact their insurance company directly to determine their specific benefits/co-pays and insurance coverage.

Note our location – we are in the two story building directly behind Oscar’s Mexican restaurant on Poway Rd.  This is the 4-way intersection and stoplight at the corner of Poway Rd. and Ipai Waapuk Rd.

 

Patient Intake Form
(Please print, fill out and bring to your appointment to save time.)

Child Intake Form
(Please print, fill out and bring to your child’s appointment to save time.)

Medical Records Release Form

Privacy Practices Form
(Please print for your own records.)

Acknowledement of Privacy Practices Form
(Required ~ Please print, sign and bring to your appointment.)