Our commitment to providing quality patient care includes making sure you have all the details about record release, financial policy, and all other necessary paperwork. If you are a new patient, please fill out the first four forms linked below that start with "New Patient". You may email them to us in advance of your appointment, or you may bring them in with you at your appointment time.
- New Patient History Form
- New Patient Billing Agreement
- New Patient Registration
- New Patient Financial Policy
- Record Release This form may be used if you would like us to send your records to another physician.
- Antigen Re-Order Form—Please fill out the top portion only if it is time to renew your antigen and fax it to (310) 453-8468.
- Consent to Discuss Treatment—If you are over the age of 18 and would like a parent or other adult to be able to discuss your treatment or billing with the office, please fill out the "Consent to Discuss Treatment" form.