Forms & Payment
Accepts new patients
| Medicare | Medicaid | Workers' compensation | Other |
|---|---|---|---|
Medical insurance plans and payment options
Office information from David G Levinsohn, MD
HIPAA notice of privacy practices formTo be read by all new patients
Directions to Sharp Memorial Pavillion Surgery Centerand Main Hospital
Directions to Sharp Memorial Pavillion Surgery Center and Main Hospital
HIPAA acknowledgement of privacy practices form
To be signed by all new patients after reading HIPAA policy. Please bring this signed form to the office and it may save time at check in.
HISTORY FORM
To be completed in detail by all new patients. Please bring this completed form with you. Filling out this form at home may save you time on checking in and may improve on the accuracy of the information you provide for example medication doses, dates of previous surgeries etc.
Insurance and demographic data
To be completed by all new patients
Ortho Surg Center La Jolla (English) Ortho Surg Center La Jolla (Spanish)
Ortho Surg Center La Jolla (Spanish)
davidlevinsohn.com
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