Thank you for taking the time to fill out our New Patient Registration and Medical History Forms using the link below. Both forms are online and are protected by HIPAA compliant encryption. Please allow 15 to 20 minutes to complete them. If you have any questions, please email us at email@example.com or call us at 818 225-0041. If you are calling after hours, please leave a message and someone will contact you either by phone or text.