Forms can be completed online through the patient portal or you can print them from our website and bring them with you to your appointment.
My medical history is somewhat complicated and I have had quite a few docs. I consider Dr. Meshulam to be one of the best doctors I have ever had. He is dedicated to fixing problems before they do serious long-term damage to your health.
I have been with Dr. Meshulam for about 11 years. I have never before had a doctor who truly cares not only about my health but about me.
Dr. Meshulam is a great doctor. He cares beyond the office and follows up on the phone himself! I couldn't ask for a better person to see for medical needs.
This is a man worthy of his title. He knows what he's doing and will do all that is necessary to help you achieve good health.
Dr. Meshulam is the most compassionate doctor I've ever had. He is thorough and always professional.
Patient Forms
Authorization for Release of Medical Information (PDF) - Allows patients to authorize the disclosure of their health information to a designated individual, company, agency, or facility. Autorización De HIPAA Para Divulgar Información Del Paciente
Authorization and Consent for Treatment (PDF) - All patients must provide their consent for treatment, communications (calls, emails, and text messaging), and agreement of financial responsibility. Autorización y Consentimiento Para el Tratamiento
Preferred Contacts (PDF) - Patients are encouraged to complete and return the Preferred Contacts Form but it is not required. Contactos Preferidos
Virtual Visit Policy (PDF) - This policy describes the process for the documentation, maintenance, and transmission of information using virtual visit technology.
Office Policies
Financial Policy (PDF) - This form advises patients of their complete financial responsibility for all medical services received without regard to insurance eligibility or coverage determinations. Política Financiera (PDF)
Notice of Privacy Practices (PDF) - Describes how health information about you (as a patient of this Care Center) may be used and disclosed, and how you can get access to your individually identifiable health information. Please review this notice carefully. Aviso de prácticas de privacidad (PDF)