Please complete the "New Patient Intake Form"
(link below), the "Patient Acknowledgement of Financial Responsibility Form" and bring it with you. If you have
access to a fax, please fax both to 510.380.7036.
If you have recent lab work, please bring COPIES of those results. Please note that HIPPA requires
that copies of tests and physicians notes may only be released with your written request. Bring with you supplements and prescription
medications you are currently taking.
If you are a new patient, please
download the form from the link below. It is a
PDF document that can be opened with
Acrobat Reader.
You can fill in the form, save it and return it to us by email. If you do not have
Acrobat Reader, you can
download a free copy of it
here.
New Patient Intake Form (Fillable PDF)
Patient Acknowledgement Form
