Become a New Patient

Thank you for choosing Center For New Medicine!

In order to for us to efficiently handle both the business and clinical portions of your medical visit, we are asking you to please download, print and complete documentation below. After thoroughly filling out the forms, please return them to our office. If you have any copies of previous lab or x-ray tests performed recently, please include them with your packet. Also, please include a copy of the front and back of your insurance card and the birth date of the subscriber of the insurance coverage. If you would like, you may fax the insurance information only to (949) 680-1881.

The forms should be mailed to or hand delivered to our office at least 3 BUSINESS DAYS PRIOR TO YOUR SCHEDULED APPOINTMENT. This will allow us time to verify your insurance benefits, prepare your chart for the practitioner, and should reduce the waiting time in our office. In the event that we do not receive your paperwork with adequate time to prepare for your visit, we reserve the right to reschedule your appointment to a later date.

Please call our office to make an appointment at (949) 680-1880.

New Patient Forms

Please FAX a copy to (949) 680-1881 or email a PDF copy to before your visit.
Click below to download New Patient Forms. 




Hyperbaric Oxygen Therapy New Patient Forms 

(Hyperbaric Oxygen Therapy Patients Only)
Please FAX a copy to (949) 680-1881 or email a copy to before your first visit.
Click below to download Hyperbaric Patient Forms.