Patient Information

New Patients

• Please ensure all paperwork has been filled out
• Bring your insurance card and photo ID
• Bring a list of all medications you are currently taking

Insurance

We are committed to making your payment and insurance process as smooth as possible. We participate with many major insurance plans and are contracted with most PPO plans. Please call our office for more details.

A note about insurance: Due to the vast and ever-changing nature of insurance policies, it is your responsibility to confirm with your insurance company that we are listed as an in-network provider for your specific plan. Please note that our individual physicians may not be listed under their names. Instead, you can verify our in-network status using our practice’s Tax ID: 95-3865023. If we are not listed as in-network, we are still happy to care for you. You have the option to be seen as an out-of-network patient or a self-pay patient. We strive to be transparent about pricing at the time of your visit to limit unexpected costs. Please call our office for more details and our team will do their best to assist you.

Payment Options

For your convenience, we accept cash, check, Visa, Master Card, and American Express.

To make a credit card payment by phone, please call our billing office at 818.918.5550. For your convenience, we also offer e-statements and accept secure, online credit card payments through InstaMed.

Patient Forms

The following forms can be filled out online and submitted via the patient portal links below. Please send additional records or inquiries to office@cffmla.com. We ask that you complete these forms prior to your appointment.

• Financial Policy – Read Only
• Notice of Privacy Practices (HIPAA) – Read Only
• New Patient Registration
• Family History Questionnaire
• Authorization for Disclosure
• Acknowledgment of Receipt of Financial Policy & HIPAA
• Acknowledgment of Receipt of Open Payments Discloser

For patients having Genetic Counseling, please download and fill out the forms below and email them to office@cffmla.com.

• Patient Information & Pregnancy Questionnaire
• Patient Rights & Obligations
• Billing Form (Genetic Counseling)

Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader logo.