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) 381-9777.

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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*Chiropractic patients, please fill out the forms below on your first visit or before your first appointment.
1.  In Network Forms

2.  Out-of-Network Forms

3.  Medicare Forms

4.  Optum/Monarch Forms

5.  Cash Forms

6.  Laser Forms

7.  PI Forms

8.  WC Forms

Locations

Find Us on the Map

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