Approximate length of visit is 40 to 60 minutes
Includes: history, exam, and treatment
Fee for Service Cost: Please call for fee schedule
FOLLOW UP VISITS:
Approximate length of visit is 20 to 30 minutes
Includes: follow up and treatment
Fee for Service Cost: Please call for fee schedule
PAYMENT OPTIONS: cash, check, MasterCard, Visa
CONSULTS: telephone consults at no charge
STEP 1:
You MUST download, save & READ the Patient Privacy Form (It includes details on HIPPA and other pertinent policies). R-click and SAVE it.
STEP 2:
Download and save the New Patient form to your desktop. Double-click, opening the file, and fill it out on your computer. Click the SUBMIT button at the bottom of the last page to electronically send the data to the office.
If you prefer to print the form out at home and bring it with you, please use the Alternate New Patient form instead. This form is non-interactive
STEP 3:
When you arrive at the office, please wait in the waiting room. I will come out to greet you when I am ready to treat you.
| Samaritan Drive Office: | M, W, Th | 8:00 a.m. - 6:00 p.m. |
| De Anza Blvd Office: | Tu, F | 8:00 a.m. - 12:00 noon |
click here for address information |
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OPTION 1: NEW!!! New Patient Form RECOMMENDED
New: Online form submission (using SSL, i.e. securely fill out your new patient form online and submit it online prior to your first visit).
OPTION 2: use PDF file submission (printed or sent via email)
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