Patient Forms
Downloadable forms
This area of the website contains the forms to be printed and completed for your new patient appointment. To avoid any delay in your appointment time, please arrive 15 minutes early with the forms completed in dark black ink. At the time of your visit, you will be asked to sign an acknowledgment that the HIPPA privacy notice was presented to you.
To avoid your visit being canceled, please make sure you hand-carry all of your Spine x-rays with you on the day of your visit. Do not have your films mailed to our office. Ensure all necessary medical records and reports are faxed to our office at (310) 423-9834 or mailed well before your visit for review.
A Message About Arbitration
At the time of your new patient appointment, you will be given an arbitration agreement. By signing this agreement, both patient and physician are agreeing that any dispute arising out of the medical services you receive is to be resolved in binding arbitration rather than a suit in court. Lawsuits are something that no one anticipates, and everyone hopes to avoid. The method of resolving disputes by arbitration is one of the fairest systems for both patient and physician. Arbitration agreements between healthcare providers and their patients have long been recognized and approved by the California courts.
By signing this agreement, you are changing the place where your claim will be presented. You still can call witnesses and present evidence. Each party selects an arbitrator (party arbitrators), who then selects a third, neutral arbitrator. These three arbitrators hear the case. This agreement generally helps to limit the legal costs for both patient and physician. This is because the time it takes to conduct an arbitration hearing is far less than a jury trial. Further, both parties are spared some of the rigors of trial and the publicity which may accompany judicial proceedings.
The goal, of course, is to provide medical care in such a way as to avoid any such dispute. We know that most problems can be solved with communication. Therefore, if you have any questions about your care, please ask us.
