Patient Information

Patient Forms

To save time during your appointment, you can fill out these forms at home and then bring them with you.

Pediatric Pulmonary Clinic

Please note: These documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here.

Cancellations

If you are unable to keep an appointment, we ask that you kindly provide us with at least 24 hours notice. This courtesy on your part will make it possible to give your appointment to another patient who needs to see the doctor.

Late Arrival

Patients arriving more than 30 minutes after their scheduled appointment will be considered late and seen only at the discretion of the treating physician. If you require X-rays during your visit, please try to arrive 15 minutes early to have these completed.

Insurance Acceptance

Our office participates with most insurance plans including Medi-Cal. Please contact your insurance carrier to verify that the doctor is contracted with your plan.

Health insurance plans may have a deductible, co-insurance or co-payment which is the subscriber's responsibility to pay. You will need to provide your insurance identification card(s) at the time of your office visit to ensure correct billing, eligibility, and co-payment information. If your insurance plan requires that you have a referral from your primary care physician, this referral must be brought with you, or you may also fax or mail us referral information prior to an appointment.

Billing and Payment

Co-payments, co-insurances and deductibles are due at the time of visit. If you have a question about your bill please call your specialist’s office.

Telephone Calls to the Office

If you have medical questions which only the doctor can answer, a message will be taken and your medical file will be given to the doctor. If your question is non-medical, a qualified staff member will be pleased to assist you. We will gladly handle prescription refill requests by fax from your pharmacy.