* English Forms:  Please help us keep your wait time to a minimum!   We request you to please fax your completed forms to 213-388-1507 before your appointment day (along with a copy of both sides of your insurance card), or bring at the time of your appointment.

       *Patient Registration Form
        - for all new patients
        - for existing patients with new addresses/phone or insurance info

       *Medical History Form - for all new patients

       *HIPAA Acknowledgement Form / Contact Preferences
         - for all new patients
         - for existing patients with new phone/contact preferences
(All new and existing patients should read and be familiar with our Privacy Policy Notice!  You can read it here online or in our office.)

       *Authorization For Release And/Or Disclosure of Medical Info
         - for new patients: to request your medical records to be sent to Dr. Diego             - for existing patients: to request your medical records to be sent from Dr. Diego to another medical provider

* Japanese Forms:

       *Patient Registration Form

       *Medical History Form

       *HIPAA/Contact Preference Page

* Spanish Forms: (coming soon!)