Patient Forms

Prescription Refills

Please call one of our 31 locations with the following information:

  • Practitioner's Name
  • Name of Medication
  • Pharmacy Name
  • Pharmacy Phone Number
  • Date of Last Refill

For narcotics such as Percocet, MS Contin or Oxycontin, plan to either come into the office for a written prescription or allow five days for the written prescription to be mailed. By law, your pharmacy must have a written prescription. Narcotic prescriptions cannot be written on weekends.

Insurance and Billing

If you are a new patient, you will fill out an insurance profile and discuss your options with us. We will make a copy of your
insurance card(s) for your file. Remember to contact the office at any point during your care if there is any change in your coverage.

Patients belonging to an HMO, POS or PPO must verify with their provider(s) that we are on your plan. It is also your responsibility to obtain the initial referral and bring it with you and to inform our office staff if you require pre-certification for admissions, treatments or tests.

We participate with most major insurance companies and will submit claims on your behalf. Please indicate primary and secondary carriers on your insurance profile if you are covered by more than one company. We also accept Medicare, although you will be responsible for the deductible and co-payment for physician care, chemotherapy medications and laboratory tests.

Co-payments are due at the time of your visit. We accept Visa, MasterCard, Discover and American Express. We will be happy to assist you in developing a payment plan.

Our staff will be happy to help you with any questions you may have.

We accept the following insurances in Arizona:

  • Aetna
  • Arizona Complete Health
  • Arizona Priority Care
  • BlueCross BlueShield Arizona
  • Banner University
  • Bright Health
  • CareMore
  • Care 1st
  • Cigna
  • Medicaid
  • Medicare
  • Humana
  • P3 Health Partners
  • Tricare
  • United Health Care
  • WellCare

We accept the following insurances in California:

  • Access
  • Accountable Health
  • ADOC (Affiliated Doctors of Orange County)
  • Advantage Care
  • Affiliated Physicians IPA
  • Allcare Medical Group
  • Allied Medical Group
  • Altamed Medical Group
  • AMVI
  • Angeles IPA
  • Applecare Medical Group
  • Associated Hispanic IPA
  • Avante Best Care
  • Bella Vista IPA
  • Brand New Day IPA
  • Bright Health Physicians
  • Brookshire IPA
  • CalCare IPA
  • Care 1st
  • Caremore Medical Group
  • Central Health IPA
  • Community Family Care
  • Doctor's Choice Medical Group
  • Esperanza Medical Group
  • Family Care Specialists
  • Fenix Medical Group
  • First Choice IPA
  • Future Care IPA
  • Genesis IPA
  • Global Care Medical Group
  • Good Samaritan Medical Group
  • Healthcare LA
  • Healthcare Partners
  • Hispanic Physicians IPA
  • Imperial Health Holdings Medical Group
  • Lakeside Medical Group
  • MaxiMed IPA
  • Medichoice IPA
  • Molina Medical Group
  • Monarch Healthcare
  • Nuestra Familia Medical Group
  • Omnicare Medical Group
  • One Care
  • Physicians Associates
  • Physicians' Healthways
  • Pioneer Medical Group
  • Preferred IPA
  • Prospect Professional Care
  • Regal Medical Group
  • Seoul Medical Group
  • Starcare IPA
  • Talbert Medical Group
  • Watts Healthcare
PPO / Private
  • AARP
  • Aetna
  • Blue Cross
  • Blue Shield
  • Cal Optima
  • Central Health
  • Cigna
  • Citizens Choice
  • Choice Care
  • Coventry
  • Greatwest
  • Health Net
  • Humana
  • Medicare
  • Medi-cal
  • Multiplan
  • Operating Engineers
  • PacifiCare
  • Secure Horizons
  • Southwest Administrators
  • The Reta Trust
  • Tricare
  • Triwest
  • Unified Grocers
  • United Healthcare
  • Aetna
  • Alignment Health
  • Blue Cross
  • Blue Shield
  • Chaffey Medical Group
  • Cigna
  • Crown City
  • IEHP
  • Elite Medical Group
  • Family Health Alliance
  • First Health Network
  • Health Net
  • Healthcare Partners
  • HealthSmart
  • Inland Empire Health Plan
  • Korean American Med. Group
  • Maverick Medical Grp
  • Networks By Design
  • Noble Community
  • PacifiCare
  • Railroad Medicare
  • Riverside Medical Clinic
  • Riverside Physician Network
  • Salud HMO y Más

We accept the following insurances in Nevada:

  • Aetna
  • Amerigroup
  • Blue Cross/ Blue Shield Commercial
  • Cigna
  • CareMore
  • Medicare
  • Medicaid
  • P3
  • Silver Summit/Ambetter
  • UHC
  • Tricare
11480 Brookshire Ave #309
United States