Get the free New Patient Packet

This document serves as a patient intake form for new patients at the UCLA Division of Plastic and Reconstructive Surgery, detailing necessary information and items to bring to the appointment.

How to fill out new patient packet

How to fill out New Patient Packet

1. Obtain the New Patient Packet from the clinic's website or reception.
2. Read the instructions provided with the packet carefully.
3. Fill in your personal information: name, address, phone number, and date of birth.
4. Complete the medical history section, including any allergies and current medications.
5. Provide information about your insurance, if applicable.
6. Sign any consent forms that are required.
7. Review the completed packet for accuracy.
8. Submit the packet to the reception desk, or follow the instructions for electronic submission.

Who needs New Patient Packet?

1. New patients seeking to establish care with a healthcare provider.
2. Patients transferring from another provider who need to provide medical history.
3. Individuals needing to update their information for an existing patient account.

People Also Ask about

What to expect at a new patient visit?

Your new doctor will likely talk about your overall lifestyle, including diet, exercise, and stress management. They might also discuss preventative care, such as screenings and tests relevant to your age, medical history and your individualized needs.

What does a new patient visit consist of?

Please bring the following items with you: Photo ID. Health insurance card(s) Copay, co-insurance or deductible. Your current medications. Names and phone numbers of all other physicians (e.g., cardiologist, gynecologist, dermatologist, etc) that you regularly see. Completed forms.

What is the 3 year rule for new patients?

Three-year rule: The general rule to determine if a patient is new” is that a previous, face-to-face service (if any) must have occurred at least three years from the date of service. Some payers may have different guidelines, such as using the month of their previous visit, instead of the day.

What happens during a new patient physical?

Physical Exams Some things that are performed during the physical include weight, blood pressure, temperature, heartbeat, as well as checking your ears, nose, lungs, throat, and eyes. A pap smear in women or a genital exam in men may also be performed to assess their different risk factors.

What does a doctor do on your first visit?

During your visit, your primary care doctor will closely examine your overall health. Whether it is just a check-up or an effort to diagnose a health problem you are experiencing, they will want to know how you feel. You can also tell them if you are feeling anything unusual.

What happens at a new patient primary care visit?

They will also ask about your symptoms, any medications you're taking, and your family history. Your doctor will also perform a physical exam, which may include checking your blood pressure, pulse, and weight.

What do you bring to a new patient?

For example, if an NP conducts a visit with a new patient, the practice must make a choice -- bill the visit under the NP's provider number or bill the visit under the physician's provider number and have the physician, not the NP, perform and document the portions of the evaluation relevant to the choice of procedure

For pdfFiller’s FAQs

What is New Patient Packet?

The New Patient Packet is a set of forms and documents that new patients need to fill out and submit to a healthcare provider before their first appointment.

Who is required to file New Patient Packet?

All new patients who are registering for services at a healthcare facility are typically required to file a New Patient Packet.

How to fill out New Patient Packet?

To fill out the New Patient Packet, patients should carefully read the instructions, provide accurate personal and medical information, and ensure all required fields are completed before submitting the packet.

What is the purpose of New Patient Packet?

The purpose of the New Patient Packet is to gather essential information about the patient’s medical history, demographics, and insurance details to facilitate their care and treatment.

What information must be reported on New Patient Packet?

The New Patient Packet typically requires the following information: personal details (name, address, phone number), insurance information, medical history, medication list, and any relevant allergies.