Comprehensive Patient Resources at Our Medical Practice
Prospective patients can print, complete, and submit their completed packet to our office. Please indicate your physician preference, while understanding our practice is currently very full, with many physicians unable to accept any new patients. Please contact our office for further clarification.
Before accessing the forms, please note that our practice is not contracted with all insurance policies, and we are unable to accept any further Medi-Cal, CMSP, or private/self-pay patients. Please contact your insurance to verify who your local contracted providers are.
Please print, fill out, and bring this packet with you to your annual preventive visit (also referred to as your wellness or WellCare exam, CPE, or complete physical exam or simply "physical").
Please print, fill out completely, and submit this form to us if you have established that you would like us to fax a request for another physician to send us your previous records. Feel free to communicate with your physician regarding which records would be helpful. We will scan and shred the desired records upon receipt unless otherwise discussed.
Please print and fill out this form to allow us to discuss your medical care with individuals of your choice.
Call us today at (530) 894-0500 for more information about patient forms.
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Contact Information
Phone: (530) 894-0500
Address: 114 Mission Ranch Blvd, #10 Chico, CA 95926
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Business Hours
- Mon - Fri
- -
- Sat - Sun
- Closed
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