MESSAGES ABOUT ACCOUNT BALANCES AND FUTURE APPOINTMENTS WILL BE LEFT ON THE CONTACT INFORMATION PROVIDED ABOVE
Our staff is trained to inform you of the financial policies of this office.
* Check Writing Policy: No check will be honored without driver’s license. All returned checks are subjected to a return check fee of $40.
* CHARGEBACK CARD: Any card that a chargeback is initiated without the consent of South Coast Neurology, Inc is subject to a $40.00 fee, regardless of the balance as well as late fees that apply to an overdue balance. Primary Insurance and Plan Insurance Address should not be required to sign
I am aware that obtaining test results may require a face-to-face consult with a licensed medical professional. Some test results cannot be given over the phone,
email and/or via facsimile. These regulations are in compliance with appropriate medical care guidelines and other government agencies within the of State of California. Initials
The following forms can be printed out as a PDF:
Patient Registration Form [PDF]