Downloadable patient forms can save a great deal of time by allowing you to download all of the forms needed in advance of your visit.
You can fill out the forms at your leisure and with all of your paperwork - insurance, prescriptions, etc. - within easy reach. This means the forms will be filled out more completely and accurately.
Please fax all FMLA/Disability forms to:
For Patients of Dr. Brisbin, Dr. Chapman, Dr. Fakhouri, Dr. Gourineni, Dr. Kronen, Jeremy Bell PA-C and Kelly Hermann PA-C
For Patients of Dr. Sarkis Bedikian
For Patients of Dr. Adam Meisel and Jon Schwermer PA-C
For patients of Dr. Svetlana Zats:
For Patients Scheduled for a Magnetic Resonance Imaging (MRI) Scan
Notice of HIPAA Privacy Practices
The HIPAA Privacy Notice describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information in some cases. You will be given a copy of our HIPAA Privacy Notice prior to your visit, and be asked to sign that you received it.