Patient Resources
Patient Forms
The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time, you will save a significant amount of time during your visit.
New Patient Forms
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.
HIPPA
The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes.
» To learn more visit www.hhs.gov › OCR Home › Health Information Privacy
Office Hours
Call the Front Office at 650.325.1511 Monday thru Friday, between 9:00AM and 5:00PM.
MDMG is open Monday through Friday with select early morning, lunch hour and early evening appointments available. There is also 24-hour on-call availability for emergencies for established patients.
Consultation Fees
Our charges are consistent with community standards.
We accept the payment allowances of Medicare and most insurance plans for medically necessary medical diagnoses, treatments and procedures.
Cosmetic Consultation
Charges for these consultations are customarily $75. It is important that you are well informed about available treatment options and that your expectations are realistic. The consultation fee will be included with the procedure fee if you have treatment that day. If you do not pursue a procedure that day, you will pay the consultation fee, however, that fee will be credited towards a future procedure within one year.
Insurance
Our doctors are providers for many different PPOs and HMOs. If your insurance provider is unable to determine if we are included in your insurance plan, call our office for assistance.
If you have HMO insurance, be sure to obtain an authorized referral from your Primary Care Physician (PCP), or you will be responsible for charges on the day of your visit.
Prescription Refills
Please contact your pharmacy at least two working days prior to finishing your medication. Otherwise, you may call our Prescription Refill Recorder 24 hours a day at (650) 325-1511 ext. 27. Please include your name and daytime phone number as well as the medication name, the pharmacy name, and the pharmacy phone number. We require two working days to process your prescription.
*The information on this site is solely for purposes of general patient education, and may not be relied upon as a substitute for professional medical care. Consult your own physician for evaluation and treatment of your specific condition. MDMG does not control the site content on related links.