New Patient Information
Prepare for Your Visit
- Be sure to bring previous medical records.
- Have yourNew Patient Forms filled out.
- Tell us all the medications you are currently taking.
- Have your insurance information.
- Dress comfortably.
- Encourage you to bring along a friend or loved one who may be able to help you make choices with your cancer team.
- Please arrive 30 minutes before your appointment time on the first visit so that we can make sure all the necessary forms have been completed.
New Patient Forms
Below is a list of patient forms for you to download, print, fill out and bring with you to your first visit.
The files are PDF files which require Acrobat Reader 7.0 or higher.
- New Patient Form
- Patient Information Form
- Health & Medical History Form
- Release of Patient Medical Information Form
- Request for Release of Medical Records & Pathology Materials URGENT Form
- Notice of Privacy Practices
- Directions to Victory Hematology and Oncology
- Patient Financial Responsibility Assignment of Benefits
- Collection Policy
- California Immunization Registry
- Advance Directive Instructions
- Advance Directive Form
Financial and Insurance
Peace of mind is extremely helpful when facing a health related challenge. For that reason we encourage people to contact their insurance companies to discuss the coverage and benefits they are eligible to receive. Also discuss the co-pays and deductibles that you may be asked to pay.
The state-of-the-art treatment available at Victory Hematology and Oncology is covered by a wide range of health plans. Check first with your insurance provider.
The insurances that we accept:
(I will send more contents regarding this in the near future).