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Request an Appointment

Please do not use this form if you have an urgent medical problem or you need to reschedule an existing appointment. Instead, contact our office at (323) 225-2550 (Los Angeles) or (818) 988-5999 (Van Nuys). After you submit your request, our appointment scheduler will respond within 48 hours. See below for forms to complete.

Patient Registration Forms

Primary Care Solutions in Los Angeles and Van Nuys welcomes you to our practice. Once you have made your initial appointment, you may preregister by downloading, printing, and completing the forms below. Doing so prior to your visit will help speed up the new patient registration process.

Please be sure to bring all forms with you to your first visit, along with any diagnostic films or other test results that may have been ordered or performed by another physician.

Downloadable Forms:

  • New Patient Registration
  • Health History

Please note:  It may take a few minutes to load the forms if you are using a slow internet connection. If you are unable to view the forms, you may need to download Adobe Acrobat for free by clicking on the icon below.

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"FINALLY, a doctor that cares about patients, not insurance payments. In a world of limits (time limits, patient limits) comes a doctor who takes the necessary time to listen and help."

GLADYS O.

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Primary Care Solutions provides weight loss, primary care services, and (EKG) diagnostics for patients in Greater Los Angeles.