Patient Forms

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Los Alamitos Office
3851 Katella Ave #125
Los Alamitos, Ca 90720
Phone: 562-735-0602

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Patient Forms

Patients can download following forms:

Release of Information Form

Patient Registration 

Appointments

 


Patient History

This form is usually done during the registration before your first office visit. If you take the time to do it prior to the appointment, the initial check in process can be expedited.




Financial Responsibility

Statement of Patient Financial Responsibility




Release of Information

By filling out this form ahead of time, we can expedite obtaining your prior medical records before your first office visit.