In order for us to see a patient, we begin by gathering information on the patient so we can do our due-diligence and save the patient time. This also allows us to verify insurance coverage in advance and gather all required documents prior to your first visit.
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There are two ways to begin the intake process:
1. Call us at (818) 763-0136 and speak with our intake department
OR
2. Fill out our patient questionnaire below based on your insurance or payment type
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Please fill out one of the intake questionnaires below:
If you are interested in coming in through private pay, please fill out the following questionnaire.
If you are interested in coming in through PPO or Medicare insurance, please fill out the following questionnaire.
