Patient Forms & Information
Our patients are the most important thing to us. That is why we make an effort to streamline the entire process, so you can focus on your normal life. Our promise is to treat patients with the utmost care and make the procedures as quick and comfortable as possible.
We understand that medical information about you and your health is personal; and we are committed to protecting medical information about you.
For billing and insurance questions, please call our office at (310) 702-6701.
Downloadable Forms
You can download these forms and print them out before your appointment, or fill them out in our office.
- Registration Form (download PDF)
- Consent Form (download PDF)
- Privacy Practices Form (download PDF)
- Patient Aftercare Instructions & Guidelines (download PDF)
- Insurance and Credit Card Authorization Form (download PDF)
- Patient Procedure Clearance form (for patients on blood thinners for medical neccessity) (download PDF)
Records and Slide Release
- Please call us at (310) 702-6701.
- Download the Records & Slide Release Form. (download PDF)
- Fax the Records & Slide Release Form to (310) 935-3039.
Participating Insurance Carriers
- Aetna
- Anthem
- Anthem Blue Cross
- Anthem Blue Shield
- Assurant
- Cigna
- Healthnet
- Medicare
- Motion Picture
- Writers Guild
Non-contracted Insurance
Carriers Policy Our policy for out of network carriers is to bill all non-contracted insurance carriers as a courtesy to our patients; however, patients may be subject to a higher out-of-pocket expense. We believe in providing the best possible care and we will work with the patient to establish a reasonable payment plan.
Notice to Consumers
Precision Aspiration & Biopsy physicians are licensed and regulated by the Medical Board of California. (800) 633-2322 mbc.ca.gov