Patient Forms

To make your first office visit as efficient and pleasant as possible, you can download, print, and fill in the form below before coming in.

No worries if you get stuck filling something out. We’ll explain anything that’s unclear when you come in, or you can call us at 626.338.7391 for help.


Patient Information Form


Note: Our form is in Adobe® PDF format, which means you’ll need Adobe Reader (or another PDF reader) to view it. You can get Adobe Reader for free here.

Some of the Insurances We Accept:


Blue Cross
Blue Shield
United Health Care

If your insurance is not listed above, please contact your closest office for further information by clicking here. We would be happy to assist you!

Frequently Asked Questions:

Q: Which types of insurance do you accept?
A: See our list in the table above, which includes private medical insurance, HMO plans, PPO plans, and Medi-Care.

If your insurance isn’t listed, you’re welcome to call us at (800) 974-5633 to check about your particular plan. Even if we’re not currently a provider, we’ll look into becoming one to serve you.

Q: What are your office hours?
A: We offer flexible hours in each of our locations, so it’s often possible to get an appointment within 24 hours — if not immediately.

And if you have special needs, just let us know. While we can’t make any guarantees, we’ll see how we can help you.

Q: Which languages can you speak?
A: You can talk to us in English, Spanish, or Persian (Farsi). If you’d prefer to speak a different language, we have a phone service to translate between us.

Q: Where are you located?
A: For driving directions and contact information, click here.

Q: What are your specialties?

A: We’re specialists in treating pain and injuries with your shoulders, elbows, wrists, hands, hips, knees, ankles and feet. For treatment, we perform sports medicine, arthroscopic surgery, arthritis surgery, joint reconstruction and joint replacement, among other techniques.

For more specifics, you can read through our Services.

Facilities / Hospitals

  • Doctor’s Hospital of West Covina | West Covina, CA
  • Citrus Valley Medical Center/Queen of the Valley Hospital / West Covina, CA
  • Inter-Community Hospital / Covina, CA
  • Monrovia Memorial Hospital / Monrovia, CA
  • Los Angeles County / University of Southern California (LAC/USC) | Los Angeles, CA
  • St. John’s Hospital in Santa Monica, CA