Please print out, complete, and bring with you to your first appointment, the following forms:
(1) New Patient Evaluation Form. Please fax this form to our office prior to your first appointment with Dr. Ambardar. [Fax (310) 360-0868]. Please also bring this form with you to your initial appointment.
(2) Please read our HIPAA Notice of Privacy Practices and sign the Acknowledgment of Receipt form.
(3) Office Policies: Please read and sign.
(4) Consent for Evaluation and Treatment Form: Please read and sign.
(5) Consent to Release Information Form: Please read and sign.
(6) Credit Card Authorization Form: Please read and sign.
