Call 831-600-7381 or email email@example.com to request an appointment.
We are in network with
Please arrive 15-20 minutes early for the initial evaluation. Download, fill out and bring the following forms with you to your first appointment.
Download and bring all of the following:
- Medical History (all 4 pages)
- HIPPA: Acknowledgement of Receipt of Notice of Privacy Practices
- Office and Billing Policy (Assignment of Benefits)
In addition, please bring:
- Patient forms to be reviewed (they do NOT need to be printed)
- All Insurance Cards
- All medical records and imaging pertaining to your current condition (most recent Doctor’s notes, Radiology report(s), Surgery report(s), X-ray(s), MRI(s)
- Any co-pay or deductible as required by your insurance
- Outcome Measure that applies to your injury (see below)
Here are the outcome measures that needs to be completed according to your injury (see description for the corresponding form):
Prior to your evaluation it is suggested that you call the Member Services department of your insurance company and verify what your responsibilities may be regarding co-pays, deductibles, referrals, etc. Please remember that benefits quoted are NOT a guarantee of payment per your insurance.
Cancellation Policy: Please call our office 24 hours before your appointment if you need to cancel. Late cancellations and no show appointments are subject to a $50 fee.
Please call our office at (831) 600-7381 if you have any questions.
We look forward to seeing you!