To Our New Patients

 

To make, change, or cancel an appointment, call our office directly at (805) 389-8111.

Our staff will assist you with your appointment needs and will answer any other questions you may have. Our staff is bilingual, English/Spanish. En nuestra oficina hablamos Espanol.

It is required that you bring with you everything necessary for your appointment. Failure to provide complete and accurate information may result in cancellation of your appointment. The first three items are required from everyone. The other items may or may not be necessary, depending upon your individual situation.

  • Insurance card, including the insurance company name and address for claims.

  • Medicare card and any secondary insurance card, if applicable.

  • Cash, check or major credit card (VISA, Mastercard, or American Express) to pay for services not covered by insurance or to pay any deductible and/or co-insurance amount identified by your insurance plan.  If we are not contracted with your insurance plan, full payment for services is required at the time of your appointment.  We will bill your insurance as a courtesy for your reimbursement.  We are not able to provide you with specific insurance plan reimbursement information.

  • Your employer’s name, address, and phone number.

  • Your spouse’s employer’s name, address, and phone number (if you are covered by insurance provided by your spouse’s employer)

  • Health Plan Referral Authorization (if required by your health insurance carrier)

  • Name, address, and phone number of your referring physician.

  • Medical records from your referring physician (your physician may have sent these to us)

  • A list of current medications, strengths of medications, and how you take each medication.

Our patient information forms are available on-line to download and complete prior to your first appointment. Click on the following PDF files to download these forms.

We look forward to seeing you.

 

Registration Form Intake Form Schedule of Charges

Se Habla Espanol