Patient Information
Forms
Fill out patient forms online prior to visiting us
Insurance
See the full list of the insurance plans we accept
Patient Education
Educational resources available for download
Non-Discrimination
View our non-discrimination policies
Language Assistance Services
We offer translation services for non-English speakers
How to – Video Visits for Patients
Read our guide on how to prepare for your first video visit
MyChart Patient Portal
Manage your appointments, access test results, and more
Open Payments Database
The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals.
Forms
If you are a new patient coming to our office for the first time or an established patient who was advised to update your information, please complete and submit the forms below.
Completing these forms before you come to the office will decrease the time you spend in our office filling out forms, thereby reducing your overall wait time.
After completing the demographics form, a confirmation window will appear. After accepting the confirmation, a second form will appear for medical history. Click on the following links to complete the forms:
*The Release of Medical Records form is to be used only if you need records transferred from an outside provider to our practice.
You will need Adobe Acrobat Reader to view and print the files. If it is not installed on your computer, please click the button to download.
Insurance
We accept the following insurance plans:
- Aetna
- Blue Cross
- Blue Shield
- Covered California
- Blue Cross PPO
- Blue Shield PPO
- Healthnet PPO
- Champus/Tricare/TriWest
- Cigna
- Firsthealth PPO Network
- GEHA
- Great West
- Healthcomp
- Healthnet
- Humana
- Mail Handlers
- Medicare
- Multiplan PPO Network
- Operating Engineers
- SeeChange
- Sharp Health Plan
- Tribal First Health
- UMR
- United Healthcare
We also accept many private PPO plans, self-insured plans, and many workers’ compensation plans.
At our Urgent Care location we also accept Mercy Physican IPA during urgent care hours only
We are primary care physicians (PCP) for Mid County and MultiCultural IPAs
Individual insurance carriers, HMOs, and PPOs vary widely in covered benefits and providers with whom they contract. Please contact your insurance carrier directly if you have any specific questions regarding your policy.
Patient Education
Non-Discrimination
San Diego Sports Medicine & Family Health Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. San Diego Sports Medicine & Family Health Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
To help people with disabilities effectively communicate with us, San Diego Sports Medicine & Family Health Center provides the following free aids and services:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, and other formats)
- Free language services to people whose primary language is not English, such as qualified interpreters
- Information written in other languages
If you need these services, contact San Diego Sports Medicine & Family Health Center’s office manager at (619) 229-3909.
San Diego Sports Medicine & Family Health Center
Attn: Office Manager
6699 Alvarado Road, Suite 2100
San Diego, CA 92120
(619) 229-3909 phone
(619) 582-1497 fax
doctors@sdsm.com
If you need help in filing a grievance, the office manager is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Language Assistance Services
Spanish
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.Llame al 1-877-696-6775.
Chinese
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-877-696-6775
Vietnamese
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-877-696-6775.
Tagalog
PAUNAWA: Kung ikaw ay nagsasalita ng Tagalog, maaari kang humingi ng tulong sa iyong wika nang walang bayad. Tumawag sa 1-877-696-6775.
Korean
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-877-696-6775 번으로 전화해 주십시오.
Armenian
ՈՒՇԱԴՐՈՒԹՅՈՒՆ՝ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք 1-877-696-6775
Persian (Farsi)
طفا توجه داشته باشید، اگر فارسی صحبت می کنید، خدمات ترجمه رایگان در دسترس است. لطفا تماس بگیرید: 6775-696-877-1
Russian
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-877-696-6775.
Japanese
注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。 1-877-696-6775まで、お電話にてご連絡ください。
Arabic
ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 1-877-696-6775
Punjabi
ਧਿਆਨ ਦਿਓ: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਭਾਸ਼ਾ ਵਿੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। 1-877-696-6775
Cambodian
ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។ ចូរ ទូរស័ព្ទ 1-877-696-6775
Hmong
LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 1-877-696-6775.
Hindi
ध्यान दें: यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं। 1-877-696-6775
Thai
หากคุณพูดภาษาไทย คุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 1-877-696-6775
How to – Video Visits for Patients
Read our step-by-step guide on how to prepare for your first video visit.
MyChart Patient Portal
Connect with SDSM through our secure portal to manage your appointments, access test results, and get answers to your medical questions from the comfort of your own home.
