top of page

Here you will be able to find the forms that all patients are required to fill out on their first visit. Please print these forms out and bring them to the office to streamline the new patient process!

 

Additionally, you will find our health insurance information, frequently asked questions, and other important information you may want to look over before coming to the office.

New Patient 
Forms

23341 Golden Springs Dr.

Suite 206

Diamond Bar, CA. 91765

909.396.7774

Monday - Wednesday   9 am - 5 pm

Thursday                          10 am - 4 pm

Saturday (Monthly)         8 am - 1 pm

Friday & Sunday             Closed

Patient Resources 

Question About Your Bill 

​​​​​What billing/insurance information should I bring?

Please bring your insurance ID card and any valid identification to our office so we can assist you as quickly as possible.

 

How long will it take to get things settled with the insurance company?

By law, insurance must respond by 30 days. Normally, our accounts are settled in within these 30 days.

 



Why am I getting bills from the office?

Normally, insurance does not cover procedures with 100% coverage. If insurance does not cover your entire procedure, you are responsible to pay any remaining balance, including your co-pay. If your insurance pays 100% of the procedure, there will be no bill.  

 



Is there anything else I should do to prepare for my office visit?

** Make sure you bring filled New Patient Forms found at the top of this page. Please print and fill out these forms before you come to the office.**

 

It is vitally important for you to know your medical information and history for us to treat you with the best care possible.

This includes:

- Allergies (Latex)

- Current medications taken

- Medical conditions 

- Emergency contact information

Accepted Health Plans 

​​- Access Dental

 

- Aetna

 

- Blue Shield, Blue Cross

 

- Cariengton

 

- Cigna PPO

 

- Delta Dental

 

- Dental Health Care

 

- Dental Health Services

 

- DMO

 

- Guardian

 

- Health Net

 

- Humana

 

- Liberty Insurance 

 

- Lincoln

 

- Medi Cal

 

- Metlife

 

- Pacific Care

 

- Pacific Union

 

- Safeguard

 

- Union Insurance

bottom of page