Before Your Visit:
Forms & Documents

In order for your first visit to be the most beneficial, for you as the patient and for us as the provider, there is some information that we will need to gather, in order to make this happen.

Please download any necessary forms (right) and submit to our office, before your scheduled apointment.  Below is a list of additional documentation, to bring to your appointment.

  • Radiology Reports (MRI, CT, X-ray)
  • Diagnostic Testing (EMG’s, NCS, Discogram)
  • Operative Reports (related to the condition we will be treating)
  • Supporting Documents (referral, insurance authorization if needed and any other documentation needed)

new-patient-registration-download

patient-follow-up-download

medical-records-download

medication-agreement-download

Fax completed forms to (949) 916-8555

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First Time Patients

Please be sure to arrive 30 minutes prior to your scheduled appointment. This will allow enough time for the finalization of paperwork, collection of your financial responsibility and for us to take your picture for your medical record.

What to bring on your First Visit

  • Valid photo identification
  • Your medical insurance card (s)
  • Reports, Films or other Diagnostic Testing relevant to your appointment
  • If you have a HMO policy, you are required to have an authorization/referral for your appointment.
  • Please be prepared to make any payments that are due on the day of  your visit such as a Co-Pay, Deductible or Cash Payment Visits.