Patient Form Download
For your convenience, we have provided the patient intake form you will need for your first appointment. You can print the form, fill it out, and then either fax or bring the completed form with you to your first visit. Please be sure to bring your insurance card with you.
Click here to view, download and print the patient Intake Form.
Patient insurance information will be available online soon.
Frequently asked questions will be available online soon.
Patient financing is provided by CareCredit®
Click the button below to apply for financing.
For our international patients, we offer the convenience of a webcam consultation by appointment with one of our Rox Center physicians using Skype, the free online webcam phone service. Whether you are in Europe, Asia or anywhere in the world, you can schedule a virtual webcam consultation.
Our offices are open Monday through Friday from 9am to 5pm Pacific Standard Time. To schedule a time for your Consultation by Appointment, please call 310.777.8800 or e-mail email@example.com. Click here to convert Pacific Standard Time to your local time zone.
Step by step instructions for a Skype based webcam consultation:
- For Skype aided webcam consultation, you have to log into Skype. You will need to set up a free Skype account and create a Skype handle (name). For your convenience, you may download Skype here.
- After logging into Skype, please add our Skype name to your contact list. Our Skype name will be given to you upon scheduling your Skype Consultation.
- After clicking on our Skype Name, you will be entered into our contact list and the video conference can begin at the scheduled time.
Following these three simple steps, you will be able to proceed with the webcam consultation.
Disclaimer: This online webcam consultation is a service provided by Rox Center. The participants in the online consultation fully understand that the information provided by the doctor is general information only and is not a substitute for an actual face-to-face consultation with the doctor that is necessary before any surgery. Participants in this consultation agree not to hold any parties liable to the opinions given herein.