INLAND PULMONARY MEDICAL GROUP

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Patient Forms

To save you time with your visit, please have these new patient forms filled out and bring them with you to your appointment. If you have any questions or need assistance, one of our staff members will gladly help.

New Patient Packet English
New Patient Packet Spanish
Sleep Patient Packet English
Sleep Patient Packet Spanish

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Insurance

- We accept most major insurance at our practice. Please call the office to speak with one of our knowledgeable staff memebers about individual coverage.

 

 

 

 

Payment

- All copays and deductibles are due at time of service. We accept cash, check, and all major credit cards.

 

 

 

 

Cancellations

- In the event you need to cancel your appointment, kindly provide a 24 hour notice. your consideration in this matter will aloow us to accomodate other patients who could benefit from an appointment. No show and cancellations not within time may be subject to fees.

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Frank J. Y. Hsu
Amarin Kongchalalai
Elbert Chang
Nicolaas Grobler
Shahram Khorrami
Rick Siriratsivawong
Gene S. Hong
Atif Qadeer
Nicole Sims
Montclair
9655 Monte Vista Ave. Ste. 402 Montclair, CA 91763
Upland
637 N. 13th Ave. Upland, CA 91786
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