Patient Information

/Patient Information
Patient Information 2014-10-06T03:18:09+00:00

 

Our staff will be pleased to assist you in any way possible and all efforts will be made to accommodate your schedule. Everyone at our office is at your service.

Dr. Glick is also on call. If there is an urgent need to reach Dr. Glick outside of normal office hours, please call the office and the doctor will be notified immediately.

Welcome to our Patient Login

Please sign in and complete your information using our secure online forms before your visit
Patient Information Form
Medical History
Virtual Consultation

We now have the ability for you to go online to our patient portal and enter your medical history directly into our electronic medical record system. Please call our office at 310.887.4406. Our reception service specialists will assist you in logging into our portal.

If you would rather download the forms and fill them out at home, please print out and fill out the following form:

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

  • Please do not mail the completed forms to the office.
  • Please bring them with you at the time of your scheduled visit.

Financing

Please follow the link or image for financing.

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Cancellation Policy

If you are unable to keep an appointment, we ask that you kindly provide us with at least 48 hours notice. This courtesy, on your part, will make it possible to give your appointment to another patient.