Existing Patients

Patient Guide

Before your visit

If you are an existing patient and have an appointment for a new service, please fill out the form for the service you will be receiving at your next appointment. 

Provide the following for the day of your visit
  • Health Insurance Identification Card
  • Photo Identification (State ID, Drivers License, Passport, etc.) 
  • List of medications you are currently taking 


Primary Care (supplemental)

English     |     Korean     |     Spanish    |   Chinese

Dental (supplemental)

English     |     Korean     |     Spanish    |   Chinese

Behavioral health / psychiatry / therapy / mat (supplemental)

English     |     Korean     |     Spanish     Chinese

CalAIM Forms

Health needs assessment

English    |    Korean    |      Spanish   |     Chinese

Housing intake

English   |      Korean     |      Spanish   |    Chinese

Agency third party homeless verification

English   |      Korean     |      Spanish    |   Chinese

At risk of homelessness verification

English  |      Korean     |      Spanish     |    Chinese

Disabling condition verificiation form

English  |      Korean     |      Spanish    |    Chinese

Self certification of homelessness

English  |      Korean     |      Spanish    |    Chinese


Patient satisfaction survey

English     |     Korean     |     Spanish     |   Chinese

patient complaint survey

English     |     Korean     |     Spanish

patient feedback form

English     |     Korean     |     Spanish


For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospital be made available to the public.

You may search this federal database for payments made to physicians and teaching hospitals by visiting this website: