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15338 Central Ave. Suite #103 Chino, CA 91710 (909) 742-9724

MEDICAL DISCLAIMER


This website contains general information about medical conditions and treatments.  The information is not intended for diagnosis or treatment and should not be treated as such. If you have any specific questions about any medical matter or think you may be suffering from any medical condition you should consult your doctor or other professional healthcare provider.




Please take a moment to print out and complete the forms listed and bring them with you to your first appointment. You may also bring these uncompleted forms with you to the first appointment, but that may lengthen your visit.

Please understand that the aim of this initial session is to provide an assessment of your mental health needs and to determine the best available treatment options, which may include referral to another provider. The evaluation is not an agreement that I will take you on as a patient.

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Credit Card Authorization

Medical Questionnaire

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