Patient Forms
Whether you are a New Patient or Returning Patient
For each visit, there will be particular registration, medical history, authorization, releases, and other forms appropriate to your type of visit.
Printing and completing registration and history forms prior to your visit can save you time on the day of your visit.
If it is not possible to complete the forms ahead of time, please arrive 15-20 minutes prior to your scheduled appointment time to complete the forms at our office.
Download Form
Fill out form online
Bill Pay
For your convenience, you may pay your bill in person, by mail, or via telephone! We do not discriminate against any form of payment, however cash payments must be made in person when you come to your appointment and should not be mailed.
Pay by Phone
Please call (855) EMG-NCV1 (855-364-6281), Monday-Friday, 7:30am – 4:30pm.
Pay by Mail
Be sure to include your invoice or account number. Please send checks to our main billing office:
Precision Medical Group, Inc
c/o MBC Systems
1809 East Dyer Road #311
Santa Ana, CA 92705
Billing provided by MBC Systems – www.mbcsystems.com
Questions about your bill
Most billing questions are best handled by your insurance company. By the time you get our statement we have done most of what we can do to resolve any billing issues. Please contact your insurance company first. If you have already spoken to your insurance company about your specific question, please call our billing office, MBC Systems, at (949) 863-0022.
Medical Records
Request Your Medical Records
To request a copy of your medical records, use the below link to download, print, complete and sign our medical records release form. The form can either be faxed or mailed to our office for processing.
Download Form
Return by Fax
Fax your fully completed and signed Medical Records Release Form to (949) 955-0220 – this is a secure fax line.
Return by Mail
Precision Medical Group, Inc
1805 East Dyer Road #110
Santa Ana, Ca 92705
Please allow 5-7 business days to accommodate your request.