PAYMENT

✓ Most Insurances
✓ Most HMOs
✓ Medi-Cal
✓ Cash Patients

Forms

Download, print, and fill out forms before your office visit.

APPOINTMENTS

(909) 255-7200

FOR EMERGENCIES, DIAL 911

Download Forms

Please download, print, and fill out the following 4 page patient intake form.

The form is a PDF file that you can fill out on your computer, or you can print it and fill it out by hand with a pen.

Please bring your completed form with you to your initial office visit with Dr. Tieng.

Patient Intake Form