NEW PATIENT FORMS
To expedite your first visit with us, please complete and bring with you the following forms. Download forms here:
- Demographic Information Form
- Financial Policy – Page 1
- Financial Policy – Page 2
- Notice of Privacy Practices (HIPAA)
- Medical History Form – Page 1
- Medical History Form – Page 2
See handouts below for helpful and useful information. Check back periodically as we continue to add new handouts.
Note – the file is in the pdf format, which requires the free adobe reader software. If it doesn’t open, Click HERE to get the free reader software. Then try again!
Request an Appointment
Fill out the form below to reach Alamitos – Seal Beach Podiatry Group, or call Los Alamitos: (562) 203-6151 or Seal Beach: (562) 242-1559 for immediate assistance.