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Porter Ranch - Primary & Specialty Care

Porter Ranch - Primary & Specialty Care

Porter Ranch - Primary & Specialty Care
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Porter Ranch - Primary & Specialty Care

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New Patients: Request an appointment

Patients can download/print the following forms and bring with them to their appointment. (You will need Adobe Reader to download PDF forms below. )

Adult Patient FormsPatient Information: UCLA Health Primary & Specialty Care office in Porter Ranch.

  • New Patient Health History Questionnaire

  • Geriatric Patient Health History Questionnaire: Part 1 and Part 2 (PHQ9)

  • Missed Appointment Policy

  • Terms and Conditions

  • Authorization for Release of Health Information

  • Email Consent Form

Hematology Oncology Patients: please refer to their page for information on what to bring with you to your first visit >


Your Feedback Matters To Us

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UCLA Health seeks to provide the best possible care and service to all patients. We want to know how we're doing, and our representative from a company called Quality Data Management (QDM) may be calling you to perform a patient survey by telephone.

  • You may be selected randomly to be interviewed over the phone within a few weeks of your visit.
  • QDM will ask you about your experience with your doctor and this practice.
  • Your responses are confidential and you will not be identified.
  • Participation in the survey will not affect your health care or your benefits.
  • We encourage you to take the survey, but the choice is up to you. We value your input because it helps us improve the quality of care we provide.

...to hear your opinion

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