Patient Forms
The following forms can be downloaded to your computer and scan to us at your earliest convenience. By filling out these forms upon receipt, you will save a significant amount of time for your visit.
New Patient Registration Form
New to our practice? Please fill out a new patient form so we can schedule you in for an appointment
Third Party Credit Card Payment Authorization Form
By filling out this form, you’re allowing Insight Choices to use your credit card on behalf of the patient for continuing care.
HIPAA Release of Information
Medical records request and/or coordination of patient care with another proivder or family members
Physician Referral Form
Thank you for your referral! We appreciate the confidence you have placed in us. It’s great to work together on helping our mutual clients to get better.
Insurance Submission
Patient Survey
We appreciate your review! Please take your time to let us know how we can do it better with our practice and with your provider experience.
PATIENT RESOURCES
Office Hours
For information or to schedule an appointment, please call us at (323) 375-0950. Monday-Sunday (7 days a week, 8:30am – 6:00pm)
Preparing for Telehealth Visit
If you are a new patient, to best utilize time, you are encouraged to send the following forms to us at newpatient@insightchoices.com as soon as possible so we can begin the verification process and create your personal online portal account.
- Picture ID
- Front and Back of the Insurance Card
- Required Referral Information or Letters as necessary
- Any required Deductible / Co-Payments
Item to note before your Appointment
- You will receive an online link via email 24 hour prior to your scheduled session with your provider.
- Please wait online or via phone at your scheduled appointment time for your online session.
- Clinic registration and payment are done prior to appointment time. To decrease your overall waiting time for an appointment as a new patient, we recommend that you send in the required documents as soon as you can since our schedule is normally 3 weeks out for our providers.
Cancellation Policy
If you are unable to keep an appointment, we ask that you kindly provide us with at least 24 hours’ notice. This courtesy, on your part, will make it possible to give your appointment to another patient. There is a $60 cancellation fee for existing patients and $100 for new patients who miss appointments or do not provide 24-hour notice.
Insurance
At Insight Choices, we believe that all insurance plans should be treated equal. Our roster of insurance plans and options is comprehensive. Every patient, regardless of their insurance type, receives the same efficient, effective and friendly service and medical care.
Payment Options
For your convenience, we accept Visa, Master Card and American Express.