Documents

We would like to sincerely welcome you to Dr. Marcella Bonnici's office and look forward to meeting you at your first appointment. If you have any questions, please do not hesitate to call our office at any time.

FOR NEW PATIENTS
Before your first appointment

We will need you to arrive approximately 30 minutes prior to your scheduled appointment time to fill out the new patient paperwork. If you are bringing the forms with you, please arrive a few minutes early so that we may verify your insurance information.

You will need to have your insurance card and driver's license or other picture identification present at the time of your visit.
If applicable, a copay will be collected at your visit. This copay amount is the Office Visit copay listed on your card. We accept Cash, Credit/Debit cards, and checks.

Please bring all previous records that pertain to your visit with you to your appointment. You may also have your previous physician fax these records directly to our office fax at (951) 816-3240 or mail them to our office. Please call in advance to verify that we have received your records so that we may avoid a possible delay in your appointment time. If your previous physician requires written consent, you can download our Authorization Request for Medical Records here.

NEW PATIENT FORMS (AGES 0-12)

NEW PATIENT FORMS (AGES 13-17)

NEW PATIENT FORMS (AGES 18+)

PRIVACY POLICIES (HIPAA) FULL VERSION FOR YOUR INFORMATION ONLY

AUTHORIZATION REQUEST FOR MEDICAL RECORDS

 

FOR EXISTING PATIENTS

Please fill out and bring to your first appointment of the new year:

YEARLY HEALTH HISTORY UPDATE

Keep your information up-to-date

These are documents for existing patients to update or change any information currently on file in our office. The Patient Registration needs to be updated yearly as this general information is necessary to keep our files current.

Location
Marcella Bonnici, MD
36320 Inland Valley Drive, Suite 201
Wildomar, CA 92592
Phone: 951-381-6958
Fax: 951-816-3240
Office Hours

Get in touch

951-381-6958

Marcella Bonnici, MD
36320 Inland Valley Drive
Suite 201
Wildomar, CA 92592