Please download this form which contains our registration information and bring it with you to your appointment. Also, please try to verify your insurance information with us over the phone prior to your visit. This will help us to keep you on time.

- Please click here to download the New Patient form.
- The form is a PDF document that can be viewed with Adobe Acrobat Reader.
- To download a free copy of Adobe Acrobat Reader click here.
- Forms can be sent via fax, snail mail, or in person during a scheduled appointment. Here is our contact information -

Rheumatology Therapeutics
18376 Clark Street
Tarzana, CA 91356

Tel: 818.996.4077
Fax: 818.996.4069
RTMCdoctor@yahoo.com

New Patient Form

When arranging for an appointment, let the receptionist know the nature of your visit. This helps her schedule the proper amount of time and reduces the need for return visits. If you need to cancel an appointment, please let us know as soon as possible. We appreciate at least 24 hours notice.

This is a copy of our Hippa Manual. Please download it for your records.

- Please click here to download the RTMC Hippa Manual.

In order for us to improve, we need your help. At your convenience, download this short survey questionaire and fill it out after your appointment. When your finished, please fax it back to us.

- Please click here to download the Patient Satisfaction Survey.
- The form is a PDF document that can be viewed with Adobe Acrobat Reader. To download a free copy of Adobe Acrobat Reader click here.
- Forms can be sent via fax, snail mail or in person during a scheduled appointment.

Patient Satisfaction Survey

Please download this form to give to your other doctors so that we can get all your old records. Please bring a copy of this signed form with you. Please bring any past medical records that you have to your appointment.

- Please click here to download the Release of Information form.
- The form is a PDF document that can be viewed with Adobe Acrobat Reader. To download a free copy of Adobe Acrobat Reader click here.
- Forms can be sent via fax, snail mail or in person during a scheduled appointment.

Patient Release Form