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500 W san Bernardino RD, STE A, Covina, CA 91722
Call : 626-966-1909 | Email : info@drmetyas.com
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Forms

Please Print, Complete All, Sign Them And Bring To Appointment:

Forms ( English and Spanish)

Consent Form and Receipt of Privacy Practice
Required
Download PDF here
Financial Policy
Required
Download PDF here
Health Questionnaire New patients form
Required
Download PDF here
REGISTRATION_FORM
Required
Download PDF here
HIPPA
Required
Download PDF here
PATIENT PORTAL INSTRUCTION
Not required
Download PDF here
Permiso para practicas privadas Spanish
Not required
Download PDF here
Poliza financiera Spanish
Not required
Download PDF here
Cuestionario de Salud para Pacientes Nuevos Spanish
Not required
Download PDF here
Espanol HIPPA Spanish
Not required
Download PDF here
Forma de Registracion Spanish
Not required
Download PDF here