Forms
Data - we can't escape paper, but we can try to minimize its use. Let's try sharing information toward your best outcomes. Safe and secure (and fully HIPAA compliant). You may either download the forms here, print them out and bring them in, or you may fill out the forms in our office with our portable tablet devices in the waiting room - all without touching a tree.
Forms Completion Policy
We are here to help you with your forms! We understand the need to document certain matters to outside agencies. Therefore, we will try our best to provide the documentation you need and fill out any necessary forms.
- Blank forms will not be accepted. Personal information must be completed.
- Turnaround time is usually fewer than 5 business days.
- Forms are completed for those accounts in good standing. Outstanding balances need to be paid prior to forms being filled out.
- Many forms require a current examination prior to being completed so an office visit may be required and is not part of the form fee.
- $45/page to read or fill out.
We have a fee for filling out forms and writing letters for outside agents since it requires careful consideration and time and insurance companies do not cover that expense. Furthermore, all forms require our signature and we are responsible for the accuracy of the information provided. Incomplete or inaccurate information may have far reaching consequences in your care and legal affairs so please make sure that the information you provide us with is accurate to the best of your ability.
This applies to may types of forms and letters including paperwork for disability, jury duty, EDD, FMLA, travel letters for missed flights, pet letters for travel and housing, water/power/utility discount forms, school physicals, camp physicals, long-term care forms, life insurance forms, etc. We may also request your permission to release the information provided by filling out a form called "Authorization to Disclose Health Information".
The fee for form processing is $45 per page required to read or fill out. For example, a form with one page of instructions to read and one page to fill out is $90.
We will complete the form and post it on your patient portal within 5 business days of the receipt of the form and its fees. To avoid delays, please return your form (with your section completely filled out) to us with your full payment. To pay your bill online, click here.
Finally, completion of certain forms, such as school forms, camp forms, sport participation forms, disability determination, etc., may require an update of your medical information or a special examination. In such cases, you will be asked to make an appointment and we will fill out the form as part of the office visit without extra charge.
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Contact Us
Feel free to ask our staff or the site manager any questions about our services. Because your satisfaction is important to us, we’ve made comment cards available in all of our offices and on this website. Please let us know how we can serve you better.
13425 Ventura Blvd., Suite 102
Sherman Oaks, CA 91423
Phone: 818-995-7784
Fax: 818-995-7786
Email: admatian@PrimeCareLA.com
About Us
Prime Care Physicians is a primary care medical practice started in response to a need for quality primary care in the local community. Our goal is to preserve the quality of the personal relationship between patient and doctor, prevent disease, and help guide our patients through the medical maze of specialists and consultations should a medical concern arise. Our long term goals are to expand in geographic locations served and services available.