Forms

Please click on the appropriate forms below and complete them before your
scheduled appointment. Thank you!

Workers' Comp Checklist:

  • Immediately file an injury report with your employer in writing.
  • If you have a dental issue, be evaluated by an expert dentist, QME preferred.
  • Hire a workers’ comp attorney for legal assistance.
  • File an injury claim with the Industrial Commission.
  • Keep track of all missed days of work, travel to doctor appointments, medical fees and out-of-pocket expenses so that you can be appropriately reimbursed.

Take the First Step:

Schedule an Initial Exam Today

Valencia: 27421 Tourney Rd, Suite 250, Valencia, CA 91355
Pomona: 1956 Indian Hill Blvd, Pomona, CA 91767
Beverly Hills: 462 N. Linden Dr, Suite 414, Beverly Hills, CA 90210
Orange County: 1401 Avocado Ave, Suite 206, Newport Beach, CA 92660
Northern CA: 1855 San Miguel Drive, Suite 10, Walnut Creek, CA 94596