Registration

Patient Registration

Now you can complete patient information and medical history information from the comfort of your own home. Please select a form from the menu below. After you complete each registration form please email or fax the form to us. Once we receive the form we will contact you in the next few days. There is also an option to print the forms from your home printer if you choose to do so.

Patient Registration PDF

Medical History PDF

If you have any questions or would like to schedule an appointment, please visit our Contact Page to submit a form or call our office at (213) 388-3636

Page Navigation

You can navigate back to our main Patient Information Page or you can select the previous or next page below.

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Other Information

We will schedule your appointment as soon as possible. We will make every attempt to see a patient the same day if they are in pain. If you have more questions about scheduling your appointment you can read more about scheduling practices. If you have never been to our office before we recommend that you read the information on our First Visit page.

Parking Information

Don’t forget that we are happy to provide free parking behind our office building for our patients. We have created a diagram and directions on how and where to park when you come for your appointment. Parking can be difficult to find and expensive, so make sure you know where to park inside the LA Medical Center Building to make your visit here convenient.

For more information please visit our Parking Information Page.