If you are a NEW patient, please fill out a new patient information form:
Click to download a PDF of the form.
Present this form to the receptionist when you arrive for your appointment.
Please bring the following to your appointment:
1. Completed Patient History Questionaire (download from link above)
2. Insurance Card and Driver’s License or California ID
3. If you have allergies, a list of all medications that apply
REMINDER: Co-pays are due on the day of your visit. Thank you.
If you are already a patient of ours, please give us a call to make an appointment.
New Office Policy – 2015
Patient responsibility for late cancellation or ‘No Show’ of appointment
You should inform the office NO LATER THAN 24 HOURS prior to your scheduled appointment if you are unable to keep the appointment. If you cancel less than 24 hours in advance or if you just don’t show up for your appointment, you will be charged a fee according to the length of time allotted for the appointment.
Regular office visits with Dr. Tanaka will be charged $45.00.
Laser procedures and other minor office procedures will be charged $50.00.
Extenuating circumstances may be considered. If you have any questions regarding these fees, please ask about them BEFORE you make your next appointment. We would be glad to answer any of your questions.
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