Below please find forms needed for new patient enrollment.

Quest Diagnostics

50 Bellefontaine, Suite 102
Make an appointment online or call:
888-277-8772
626-584-3007

Patient self-service portal now available:

www.patientfusion.com

NEW PATIENT INFO

Please complete the Patient Form, print, and bring with, or attach completed form to an email addressed to office@doctorellenmcdonald.com:

Email transmits your personal information in the clear and is not HIPAA-compliant:

PatientForm.pdf

PatientFormOnline.pdf

To request your records from other physicians please use the form below. If filled out for each physician before your appoinment, office time will be reduced:

PatientFormRecordReq.pdf

Please print form below - keep for your records:

PrivacyofPersonalHealth.pdf