Forms
For your convenience, we have posted all the forms you may need in order to access our services. Viewing these forms requires that you have Adobe Acrobat. If you do not have Adobe Acrobat, you can click here to download the latest version.
New Patients
Choose the appropriate new patient packet below based on which physician you will be seeing in our office. Please print the packet and complete and sign all documents prior to arriving at the office for your scheduled appointment. There are additional steps to the registration process that must be completed at the office on your first visit, so please be sure to arrive 30-minutes early so that you can make your appointment time.
The following forms are all part of the new patient packet. We have posted them online in case there is a specific form that the office has requested you complete prior to your office visit.
- Dr. Beyer New Patient Packet
- Dr. Beyer New Patient Packet (Knee)
For new patients with a knee injury - Dr. Caillouette New Patient Packet
- Dr. Charlu New Patient Packet
- Dr. Dennis New Patient Packet
- Dr. Desai New Patient Packet
- Dr. Gausewitz New Patient Packet
- Dr. Gausewitz New Patient Packet (Knee)
For new patients with a knee injury - Dr. Gazzaniga New Patient Packet
- Dr. Gerken New Patient Packet
- Dr. Gordon New Patient Packet
- Dr. Ip New Patient Packet
- Dr. Lee New Patient Packet
- Dr. Lee New Patient Packet (Back and Neck)
For patients treating with Dr. Lee for back and neck pain - Dr. McNair New Patient Packet
- Dr. Petrie New Patient Packet (Knee)
For patients with knee pain - Dr. Petrie New Patient Packet (Shoulder)
For patients with shoulder pain - Dr. Safman New Patient Packet
- Dr. Ting New Patient Packet
- Dr. Tischler New Patient Packet
Other Forms
- Medical Records Release
To obtain a copy of your records, complete this form and mail or fax it to our office at (949) 630-4924. - DMV Disabled Person Placard or Plates (REG195)
DMV Application for disabled person placard or plates. After completing your portion of this form, your doctor will have to complete his/her part before it can be sent to the DMV. - EDD Claim for Disability Insurance Benefits (de2501)
The patient must complete and sign pages 1 and 2. The doctor must complete and sign page 3 and mail all 3 pages to the nearest State Disability Insurance office.