Patient Instructions & Forms

Preparing for your Visit at The Bethencourt Group

Complete and accurate records and information is important for your care.

Please be sure to read, complete, & sign where indicated on all of the forms provided.

Required Forms for New Patients

Obtaining Forms

  • You can download New Patient forms below 
  • We’ll be glad to email you our New Patient forms – Contact our office
  • We’ll be glad to mail you our New Patient forms – Contact our office

Completed Forms

  • You can drop off, email, or fax your completed forms prior to your appointment (preferred)
    • Call our office at 562-988-9333 for information
  • Call 1 hour prior to your appointment
  • Let us know in advance if you will need an interpreter and what language

Bring the following to your appointment

  • Your completed paperwork
  • Insurance card
  • Picture ID
  • Any information requested at the time your appointment was made
  • If applicable include your referring physician and primary care physician’s information

Download Patient Forms

To view the forms listed below, you will need Adobe Reader.