March SpecialsHerbal Body Wrap for detoxification(herbal experience of warmth and relaxation…includes head & foot massage and free detoxification bath herbs) $65 Hair RemovalSoft, Silky Smooth Skin Product DiscountsObagi Medical and Mention this ad when you call, 707.279.8733Print this coupon,
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Paula R. Dhanda, M.D., F.A.C.O.G., F.A.C.S. |
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New In Office Procedures Covered by Most Insurances! |
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Medical forms for viewing and downloadingThese various forms are in PDF format for viewing, downloading and printing. New Patient PackHealth Questionnaire10374 Health Questionnaire.pdf (50.5k) Patient Information Form10743 Patient Info Form.pdf (32.4k) Payment Plan Form Letter10744 Payment plan form letter.pdf (27.8k) Medication ListMEDICATION LIST.pdf (50.2k) Patient Partnership PlanPatientPartnershipPlan.pdf (63.5k)
Medical FormsPost-operative Patient Instructions, Major Surgery1004 Post Op Major.pdf (33.5k) Post-operative Patient Instructions, Minor Surgery1005 Post Op Minor.pdf (31.7k) Health Questionnaire10374 Health Questionnaire.pdf (50.5k) Patient Information Form10743 Patient Info Form.pdf (32.4k) A Patient’s Bill of RightsPatientsBillOfRights.pdf (24.6k) Advance Health Care DirectiveAdvanceDirective.pdf (81.4k) Payment Plan Form Letter10744 Payment plan form letter.pdf (27.8k) Authorization for Use and Disclosure of Medical Information10812 Request for Records.pdf (33.5k) Medication ListMEDICATION LIST.pdf (50.2k) Gardasil Purchase AgreementGardasil Pirchase Agreement.pdf (32.0k) EDD Disability Forms | ||
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.