Patient Resources
Need To Make A Payment?
If you know your statement balance and would like to pay it now, please use this link to our secure Online Patient Payment Portal
Online Patient Forms
Only use the below link if you would like copies of your records for yourself. Records requests received via online submission will need to be picked up in person and signed for at that time. There is a processing fee of $20.00 payable upon pickup.
Patient Forms
The following forms can be downloaded to your computer and printed at home.
Note: These files are in PDF format. If you do not have Adobe® Reader® on your computer, you can download it for free by clicking here or on the Get Adobe Reader icon.
HIPPA
The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes.
» To learn more visit www.hhs.gov › OCR Home › Health Information Privacy
Office Hours
Consultation Fees
Our charges are consistent with community standards.
We accept the payment allowances of Medicare and most insurance plans for medically necessary medical diagnoses, treatments and procedures.
Cosmetic Consultation
Charges for these consultations are customarily $75. It is important that you are well informed about available treatment options and that your expectations are realistic. The consultation fee will be included with the procedure fee if you have treatment that day. If you do not pursue a procedure that day, you will pay the consultation fee, however, that fee will be credited towards a future procedure within one year.
Insurance
Our doctors are in network with most major commercial PPOs and Medicare. We also participate with Hill Physicians HMO San Francisco Bay Region. If your insurance provider is unable to determine if we are included in your insurance plan, call our office for assistance.
For those with HMO insurance through Hill Physicians, be sure to obtain an authorized referral from your Primary Care Physician (PCP), or you will be responsible for charges on the day of your visit.
Prescription Refills
Please contact your pharmacy at least two working days prior to finishing your medication. Otherwise, you may call our Prescription Refill Recorder 24 hours a day at (650) 325-1511 ext. 27. Please include your name and daytime phone number as well as the medication name, the pharmacy name, and the pharmacy phone number. We require two working days to process your prescription.
*The information on this site is solely for purposes of general patient education, and may not be relied upon as a substitute for professional medical care. Consult your own physician for evaluation and treatment of your specific condition. MDMG does not control the site content on related links.