Registration Form
New Patients: Please DOWNLOAD, REVIEW and COMPLETE, then PRINT to MAIL or FAX or Email the relevant forms for the service you need back to us and we will contact you. For questions about different services, or if you prefer electronic forms to be completed and signed online, please contact us. For more details on our billing rates and policies, please refer to **About Insurance & Fees below.
Complementary Consultation Terms and Consent†
New Patient Initial Case Review & Virtual Consultation Registration (Domestic patients only)
Established patient follow-up Email / Phone / Virtual services Registration
International Patients Initial Case Review / ZOOM Virtual Consult / Email Registration
Medicare Opt-Out Notice (for Medicare patients only) – pls call
Tibetan Medicine Consult Consent
† Required forms for any type of domestic (USA) consultation, in person, virtual or medical records reviews with Dr. Raymond Chang
