September Special

Welcome Fall with a warm relaxing Hot Stone Massage and custom Aromatherapy essential oil.
$80.00

60 minute treatment
($100.00 value)
Call today to schedule!!

Specialty Care & Surgery Center
5685 Main Street * Kelseyville
707.279.8733

 

 

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Paula R. Dhanda, M.D., F.A.C.O.G., F.A.C.S.
Quincy C. Andrus, P.A.
John C. Clarke, C.R.N.A.

Dedicated to a Higher Standard of Care

New In Office Procedures Covered by Most Insurances!


A quick, safe, and effective minimally invasive procedure that can eliminate heavy periods.


A permanent birth control option. It is a proven solution that doesn't require hormones, cutting, going under general anesthesia, or slowing down to recover. When your family is complete, choose Essure.

Call our office for more information 707.279.8733

Medical forms for viewing and downloading

These various forms are in PDF format for viewing, downloading and printing.

New Patient Pack

Dear New Patient

DearNewPatient.pdf (58.7k)

Health Questionnaire

10374 Health Questionnaire.pdf (50.5k)

Patient Information Form

10743 Patient Info Form.pdf (32.4k)

Payment Plan Form Letter

10744 Payment plan form letter.pdf (27.8k)

Medication List

MEDICATION LIST.pdf (50.2k)

Patient Partnership Plan

PatientPartnershipPlan.pdf (63.5k)

 

Medical Forms

Post-operative Patient Instructions, Major Surgery

1004 Post Op Major.pdf (33.5k)

Post-operative Patient Instructions, Minor Surgery

1005 Post Op Minor.pdf (31.7k)

A Patient’s Bill of Rights

PatientsBillOfRights.pdf (24.6k)

Privacy Practices

PrivacyPractices.pdf (1.4mb)

Advance Health Care Directive

AdvanceDirective.pdf (81.4k)

Authorization for Use and Disclosure of Medical Information

10812 Request for Records.pdf (33.5k)

Gardasil Purchase Agreement

Gardasil Pirchase Agreement.pdf (32.0k)

EDD Disability Forms

EDD Disability Forms.pdf (1.2mb)

 

Specialty Care & Surgery Center • 5685 Main Street, Kelseyville, CA 95451

707-279.8733, FAX 707.279.8731 • info@dr-specialtycare.com

 

Specialty Care & Surgery Center does not discriminate against any person on the ground of race, color, national origin or on the basis of disability or age.

NOTICE TO CONSUMERS: Medical doctors are licensed and regulated by the Medical Board of California  (800) 633-2322  www.mbc.ca.gov