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MAKE AN APPOINTMENT 




* Email Address:
* First Name:
Middle:
* Last Name:
* Date Of Birth:
* Daytime Phone: ( ) -
Evening Phone: ( ) -
Cell or Other Phone: ( ) -
   
Name of Physician:
1st Choice:
2nd Choice:
3rd Choice:
   
* Do You Have Health Insurance? Yes No
Insurance Company:
Id Number:
Insurance Co. Phone: ( ) ext.
Group Number:
* Existing Patient? Yes No
   
Office:
Reason:
Prefer: -
  -


                                

  

 

 

Are You A New Patient?
If you are a new patient making your first appointment with SMBP, please come to the office a full 15 minutes before your appointment time out the always popular new patient paperwork. If you have insurance please bring in your insurance card. You may also bring your medical records, xrays or documents that you feel will be relevant.


Accepted PPO Plans
If you are a new patient making your first appointment with SMBP, please come to the office a full 15 minutes before your appointment time out the always popular new patient paperwork. If you have insurance please bring in your insurance card. You may also bring your medical records, xrays or documents that you feel will be relevant.

 
Accepted HMO Plans
If you are a new patient making your first appointment with SMBP, please come to the office a full 15 minutes before your appointment time out the always popular new patient paperwork. If you have insurance please bring in your insurance card. You may also bring your medical records, xrays or documents that you feel will be relevant.

 

Accept Medicare Plans and All Private Health Insurance 

 

Hours of Operation

Appointments
9 AM - 5 PM Monday - Friday


Wilshire Urgent Care
5:30 AM - 9 PM Moday - Friday
10 AM - 2:30PM Saturday/Sunday


Playa/Marina Urgent Care
9 AM - 9 PM Monday -Friday
9 AM - 6 PM Saturday/Sunday

 

                

For Patients