Patient Forms

DOWNLOADABLE FORMS

PLEASE READ

We Can Verify Your Insurance Benefits. All we need is… Your driver’s license and insurance card info.

Patient Forms

Please fill out the appropriate medical form for female, male or pediatric online or download, print & fill out before your provider arrives or you will be charged for the time at the evaluation rate of $50 every 15 minutes your provider assists, fills out, or waits for you to fill out the appropriate paperwork. If you need assistance before your provider arrives, please:

CALL: (310)997-2643 or 

FAX: (310)997-2665 or

E-MAIL: scheduling@LAMobileAcu.com

Someone will get back to you within 48 hours. Thanks for your patience and understanding.

WE ARE HERE TO HELP YOU LIVE BETTER