New Patient Packet
If you are joining the practice, this is the only thing you need. The packet brings together everything a new patient has to complete: our notice to patients, what to bring to your first appointment, our no-show policy, our prescription refill policy, and the registration, health history and consent forms.
Complete the packet before your first visit and bring it with you, or arrive 30 minutes early and complete it here.
Patient Registration Form
Your personal details, address and contact numbers, insurance information, preferred pharmacy (local and mail order), and your consent to our appointment, no-show and refill policies. This is also where you tell us you would like access to the patient portal — just give us a valid email address.
Adult Health History
Your medical background: conditions over the past ten years that required hospitalisation or more than two weeks of treatment, previous injuries, surgeries, medications and family history. This is the form that gives the doctor the fullest picture of you, so it is worth taking your time over.
HIPAA Compliance and Patient Consent
Sets out how we handle your confidential medical information, who we may and may not share it with, and lets you authorize family members or others to receive information about your care. It also confirms you have read our Notice of Privacy Practices.
Adult TB Exposure Risk Assessment
A short set of yes/no questions about tuberculosis exposure and travel, used to work out whether a Mantoux tuberculin skin test is needed. Often requested for employment, school or care work.
Cancer Family History Questionnaire
A screening tool that records cancers in you and in your close blood relatives, along with the age at diagnosis. It helps the doctor identify hereditary cancer risk and decide whether further screening would be worthwhile. Bring what you know — you don't need every date to be exact.
Would you rather have them on paper?
Not everyone wants to print forms at home, and not everyone should have to. Call the office on (951) 303-6158 and we will post the forms to you or email them, whichever is easier. You are also welcome to pick up a packet from the front desk during office hours.