For new patients, here are some forms that you can download/print out and sign prior to coming into our office. Please come 15 minutes prior to your appointment and bring your ID, your insurance card, authorization (HMO patients only), any relevant labs, and a list of any medications that you are currently taking.
4.a) Statement of Patients Financial Responsibility Form
OR
4.b) Spanish Translation-Statement of Patients Financial Responsibility Form
Korean Version- Intake Form and Patient Responsibility Form (please also use #2- HIPAA consent form and #3- SGVSC disclaimer)