New Patient Forms


 

Welcome to our practice. We are committed to make your new patient on boarding experience a good one. Instead of waiting in the waiting room to fill out the paperwork, you can read and sign the paperwork prior to your visit. 

1. New Patient Form, this is to help us establish your chart.

2. Patient Rights and Responsibility, please read and sign.

3. HIPPA, this is a notice of privacy, please read and sign.

4. Staying Healthy Assessment, this is required by the California Department of Health Services for all Medi-Cal members to fill out within 120 days of becoming a Caloptima member. If a different language is needed, please go to:
https://www.caloptima.org/en/Providers/ManualsPoliciesAndResources/HealthEducation/StayingHealthyAssessments.aspx

5. Patient Portal Instruction, we provide patient portal for free messaging with office staff, appointment scheduling, download and sharing lab result, sharing each visit diagnosis and treatment plans. For a paid services of house call, video visits, and phone visits.

Location
Shawn Hamilton, MD
4902 Irvine Center Drive, Suite 105
Irvine, CA 92604
Phone: 949-651-9671
Fax: (949) 653-0556
Office Hours

Get in touch

949-651-9671