Patient Forms
Save time: bring your forms filled out
Download, print, and complete these at home, and your first visit gets faster. Every form is also available at the front desk, with help filling it out.
Sliding fee discount
Applying for the discount? Bring this application plus a simple proof of household income. The sliding fee page explains how the program works.
Get Help
What do you need today?
A few quick taps, completely confidential. Answer right here on the page.
We accept Medi-Cal, Medicare, and most plans
No insurance, or not sure what you have? You are still welcome, and our team helps you apply for Medi-Cal.
Sliding-fee scale available based on household income.
- Medi-Cal and Medicare welcomeAlong with IEHP and most major plans.
- Free coverage checkWe call you back with a clear answer.
- Sliding-fee scaleCosts adjusted to your income when you are uninsured.
Frequently Asked Questions
Straight answers to the questions we hear most. Anything else? Call us, day or night.
Do I have to fill these out before coming in?
No, it just saves time. Every form is available at the front desk, and the team happily helps you complete them there.
I cannot print at home. What do I do?
Just come in: paper copies are at every front desk. Nothing on this page is a requirement to be seen.
Your family deserves good care, close to home.
Request an appointment or check your coverage. Medi-Cal and most plans accepted, and nobody is turned away for inability to pay.