You can make an appointment to see one of our physicians during normal business hours at any of our three locations by contacting the office directly. Once scheduled, you will receive a reminder call two days prior to your appointment. Due to the nature of our specialty there may be emergency appointments that can lead to unscheduled delays. We will keep you informed of delays and reschedule appointments as necessary.

What to Bring to Your Appointment

  • Insurance information and cards
  • Co-pay and deductibles payments
  • A list of medications you are currently taking
  • Any recent medical records an/or x-rays from other physicians pertaining to your diagnosis
  • Referral Form/Authorization from your referring physician if necessary

Prescriptions and Refills

Prescriptions and refills should be completed during a regular office visit. Refills can be handled over the telephone during regular office hours when the patient’s chart and information are available to the physicians and staff. Providing prescriptions and refills over the phone after hours is discouraged because medical records are not available, therefore these requests will only be honored under extreme circumstances.

Please allow 24-72 hours to process any and all prescription refill requests. Refill requests should be made before you are completely out of your medication. These requests can be made by either contacting your pharmacy or calling the office directly.

No Show Policy

We understand that situations arise in which you must cancel your appointment. It is therefore requested that if you must cancel your appointment you provide more than 24 hours notice. This will enable for another person who is waiting for an appointment to be scheduled in that appointment slot. With cancellations made less than 24 hours notice, we are unable to offer that slot to other people.

Office appointments which are cancelled with less than 24 hours notification may be subject to a $20.00 cancellation fee. We understand that Special unavoidable circumstances may cause you to cancel within 24 hours. Fees in this instance may be waived but only with management approval.

Medical Form Completion

Effective May 1st 2014, Peninsula Kidney Associates will be charging for form completion. You may need us to fill out forms with your health information to present to third parties. These can relate to life/health/disability insurance, DMV issues, Family and Medical Leave act, or any certificates of current medical status. Completing these forms takes administrative time to pull the necessary records, the doctor’s time to review the record and then up to an additional 30 minutes to complete the requested form, depending on the complexity.

Patient Forms

We want to ensure that your initial visit runs as smoothly as possible. Below are several forms that you’ll need to fill out at your first appointment. Please print and complete the forms, then bring them to your appointment.

New Patient Paperwork

Registration Form

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Health History Form

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Notice of Privacy Practices

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Disclosure of Protected Health Information

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Additional Forms

Form Completion Policy

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Form Completion Request

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Patient Satisfaction Survey

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Medical Record Release Form

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Application for Hardship Waiver

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