First Visit Paperwork

Prior to your initial appointment, please print and fill out the forms at the bottom of this page, including signing the Consent/HIPAA form and, if necessary, review the Medicare form.

Initial Visit Forms:  Adults age 18 or older and Babies and Children under age 18  (Please return via email or fax prior to your visit so your doctor can review prior to the visit)

Form for Motor Vehicle Accident Cases

All Medicare patients must sign a private contract acknowledging that there will be no reimbursement from Medicare for care provided in this office.

Please Read Our Privacy Practices Here

If you have any problems, please call the office and we will fax or email the documents. You may also arrive to your first appointment 15-20 minutes early to fill out the paperwork in our office. There is a clipboard in our waiting room with a copy.

mapMap and Directions online

Wear loose, comfortable clothing – please no skirts or tight jeans. You will remain clothed throughout, just removing shoes, belt, watch and any items from your pockets. Please refrain from wearing scented products and perfumes as many of our patients have sensitivities.

The initial appointment will be one hour. After reviewing your medical history, we will perform a general medical exam as necessary followed by an Osteopathic structural exam and treatment. Follow-up visits are 30 minutes. At the disrcretion of the physican, newborns may be seen as follow-ups for mothers who were seen during pregnancy and/or after delivery.

Policies:

  • Payment is required at the time of your visit. Cash, check, and all credit and debit cards are accepted for your convenience.
  • You will receive a bill to mail to your insurance, but we do not bill insurance directly. Reimbursement is likely only from auto insurance (possibly up to 100%) or some PPO policies (20-60% once deductible has been met).
  • We do not accept Worker’s Comp or HMOs (including Kaiser). We only see Medicare patients independently of Medicare coverage. You will not be reimbursed by Medicare, MediGap or any other supplemental plans. You must sign a contract acknowledging that you will receive no coverage from Medicare.
  • We require two full business days notice for cancellations, otherwise the usual fee will be charged. (48 hours except for Monday appointments, which must be cancelled by Friday morning.)
  • As a courtesy, you will receive an automated text or phone call 2-3 days in advance of upcoming appointments. Please confirm or cancel your appointment by replying directly to the text or, if you answer the call live, by following the instructions.  However, if you only listen to the voice message later,  you must call or text us directly to confirm or cancel. If you do not receive a message at all, please text, email or call us to confirm that you are in our books.
    • Please note that the automated texts will come from a five digit number, 741-21. Please do not reply to this text with any other messages except to confirm or cancel.
    • To reach our staff person, Carolina, with other messages please use our regular number (415) 255-5729 or email at info@do-sf.com.
  • For your first appointment, please confirm with us a few days prior to the appointment. If we do not hear from you, we will have to cancel it.

Our Policies and Directions in PDF format


2299 Post St. Suite 308, San Francisco, CA 94115 • call/text 415-255-5729 • info@do-sf.com