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Patient Forms

 

 If you are a new patient, please complete the registration form(s) prior to your visit to save time.


New Patient Adult Registration


New Patient Child Registration

Contact Us

We encourage you to contact us with any questions or comments you may have. Please call our office or use the quick contact form below.

Testimonials

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Office Location

  • Azusa
  • 613 N. Azusa Ave, Suite B
  • Azusa, CA
  • 91702
  • Map & Directions
  • Call: 626 334-2171