New Patients & Forms

Please complete all of the following forms before your appointment. If you are unable to submit your paperwork in advance, please call our office and ask to speak to a receptionist for assistance.

-Click Below to View and Download Forms-

In order for us to review your information in a timely manner, please mail or fax all of the above forms to our office so that we may receive them two days before your scheduled appointment:

530 Camino Mercado, Suite 536

Arroyo Grande, CA 93420

Tel:  805-540-0279

Fax: 805-439-1070

What to bring to your appointment:
Insurance Card*
Driver’s License/Identification Card
Current Medication List

*Please note that if you are unable to provide your insurance card, you will be responsible to pay in full for the provided service.*



Anthem Blue Cross

Blue Shield

United Health Care (Optum only)

Tricare (Our of network benefit providers)


Beacon (Out of Network Benefits Only)


We are currently working on accepting other insurances.