Evergreen Pediatric Associates Inc.
Helping your family care for the health and growth of your children.
Home » New Patient Registration
 

If you are a new patient who has never register with our office previously, first call 408-270-3374 to register and schedule an appointment. Please have your insurance card ready. This could take up to 10 minutes.

You can download the following forms to fill in before your scheduled appointment:

  • Consent to Treat and Financial Agreement
  • HIPAA (privacy form)
  • Insurance Verification Form

Bring the above forms along with your insurance card and photo id to the front desk receptionist for your appointment check-in.

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  • About Us
    • Linda Ha, MD
    • Christopher Vu, MD
    • Office Staff
  • Hours and Location
  • Scheduling Appointments
  • New Patient Registration
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  • Terms & Conditions of Use
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1569 Lexann Ave, Suite #232
San Jose, CA 95121
(408)270-3374
Fax: (408)270-3384