Steven B. Wasserman, R. N., D. C. offers our patient form(s) online so you can complete it in the convenience of your own home or office.

  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print it out and fill in the required information.
  • Bring your printed and completed form(s) to your appointment or Fax them to (562) 430-7544.

New Patient Health History Form - Required

This let's us know the history and current state of your health. What questions, concerns, goals, regarding wellness can we help you with? Let us know!

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Forms to Download and Print   

*Please bring in the forms filled out on your first visit or fax them before your first appt. to (562) 430-4949


1. In Network Forms

2. Out-of-Network Forms

3. Medicare Forms

Locations

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Office Hours

Los Alamitos Office

Monday

8:00 am - 12:00 pm

2:30 pm - 6:00 pm

Tuesday

Closed

Wednesday

8:00 am - 12:00 pm

2:30 pm - 6:00 pm

Thursday

Closed

Friday

8:00 am - 12:00 pm

2:30 pm - 5:00 pm

Saturday

Closed

Sunday

Closed

Los Alamitos Office

Monday
8:00 am - 12:00 pm 2:30 pm - 6:00 pm
Tuesday
Closed
Wednesday
8:00 am - 12:00 pm 2:30 pm - 6:00 pm
Thursday
Closed
Friday
8:00 am - 12:00 pm 2:30 pm - 5:00 pm
Saturday
Closed
Sunday
Closed