For Your Visit

med-formsWe need to collect certain information necessary for your visit. Please download and complete our FORM 1 and FORM 2. You can fill in all the applicable boxes and then print and complete all other fields. In order to obtain the records from you previous doctors you need to send them a signed request – FORM 4. Your records will be sent directly to our practice.

You can download our forms here in PDF format:

FORM #1   FORM #2

FORM #3   FORM #4

Please remember to bring forms to your appointment. THANK YOU!

MEDICARE PATIENTS:

We accept all Medicare plans. Our staff will provide you with all medical procedures and treatment options necessary for you to get better.  It is your responsibility to check with secondary insurance if your visit is covered prior to seeing the doctor. You personal insurance plan may have certain limitations or restrictions.

Our Offers to Cash Patients:

$FREE PULMONARY TEST
Free pulmonary test and 10 pricks with initial consultation.

$FAMILY SPECIAL
Every family member of our patient receives 20% discount.

$FALL ALLERGY SPECIAL
50% discount for seasonal allergy consultation.

$ALLERGY SHOTS PLAN
$50 credit toward in-office shots, ALL-visits-inclusive plans available.

*Offers apply to cash payments only. Offers cannot be combined.

Our Fees

We offer inclusive yearly plans and Pay-per-service:

  The inclusive plans are designed for patients having chronic issues that involve multiple tests, procedures and visits.

  Pay-per-service can be used for the services not covered by inclusive plans or as single appointment payments. All services (including Doctor’s time) will be provided only upon your full agreement with treatment contract obligations. Doctor determines what is necessary for your diagnostics and treatment and will discuss treatment and procedures with you during the appointment.

  We do not charge for laboratory tests – billing will be done by the laboratory and covered by your insurance (please check with your benefits for laboratory tests with your insurance carrier).

We are willing to make every effort to work out plan of payments for the diagnostic procedures and treatment.
Our fees are affordable and competitive for Northern California.

1

Cash price for your office visit and procedures will be presented to you in a treatment agreement and will be payable at the time of the visit. No hidden fees and multiple discounts available!

2

You can use Flexible Spending Account to pay for all services provided in our office – we also accept debit cards or can provide you with a receipt and explanation of services for reimbursement.

3

A medical credit card is available for you to pay for the services – exceptional promotional rate and very easy to be approved for.

4

As a courtesy we will generate and print an insurance claim form, which you will have to mail to your insurance company to receive reimbursement – the check will be sent to you directly from your insurance provider.

We accept cash and all major credit cards.

credit-cards