patient forms & FAQs
patient forms
New Adult Medicine Patient Packet
Print One (1) for each patient
Notice of Privacy Practices
( Printing Optional )
New Adult Medicine Patient Packet
Print One(1) for each patient
New Pediatric Immigration Patient Packet
Print One(1) for each patient
Applicant Instruction for USCIS Form I-693
Notice of Privacy Practices
( Printing Optional )
New Pediatric Patient (Ages 7-17 ) Packet
Print One(1) for each patient
Notice of Privacy Practices
Printing Optional
Caregiver's Authorization Affidavit
Request for Specific External Medical Records
Request for Medical Records
Notice of Privacy Practices
( Printing Optional )
Office Policy
( Printing Optional )
FAQs
We require a minimum 24 hour notice prior to your appointment for cancellations and reschedules. We understand certain situations arise and cancellations or rescheduling your appointment may be necessary. Please make sure to notify us if you are not able to make your scheduled appointment to avoid having to pay a “no show” or late cancellation fee.
Our goal is to build and maintain engaged professional relationships between staff, doctor and patients. You may call us directly or send us a note via our secure messaging patient portal and we strive to respond within 48hours and in most instances, much sooner.
We strive to maintain an ethical approach to your care, including professional fees which are set to reflect our level of service and consistent with the local area. A payment is required at the time of service. We accept cash and credit card payments.
Having a medical insurance generally affords a patient peace of mind against unexpected health expenses. Nowadays, however, some patients feel that even with insurance, they are still incurring costs. These are most likely high deductible plans. With this type of health plan, please expect that you are generally responsible for office charges until you meet your annual deductible. If you have co-insurance, we will collect $100 at the time of service, but please note that this amount may not reflect your total patient responsibility after your insurance is billed.
We are credentialed with most major insurances. Please click on the link to see insurances we take.
Yes! We have designated visit slots but we will do our best to accommodate same day visits depending on the nature of the visit and doctor availability. If you think it is a medical emergency, please proceed to the ER or call 911
Our office hours are MON-THU from 8am-3pm, with an hour lunch break from 12noon-1pm and Friday, 8am-1pm (no lunch time ) and telemedicine appointments from 3pm-5pm.
Please allow at least 2 business days for refill requests to be authorized. For home delivery prescriptions, please allot 2 weeks. In most instances, Dr. Perez reviews them much sooner.
Unfortunately, we cannot refill controlled substances after hours or on weekends and holidays.
No, you do not need a referral to see us, and we are welcoming new patients! If you have health insurance, please contact your insurance plan to review your coverage and physician network. We assist patients to verify insurance eligibility prior to your appointment and when you arrive for same day visits.
Yes, we do. For new patients, you will need to complete our patient registration forms prior to the visit. We can send these forms by email or you may download the forms from our website. Co-pays are due at the time of your visit and will be collected electronically.
We value your time and also advocate for continued efforts to lessen paper work. We utilize a payment system capable of securely keeping your payment information. It is PCI compliant. This enables us to improve our billing efficiency which in turn leads to less payment calls or patient statements. You will still receive a copy of your EOB and receipt through the patient portal or upon request.
To avoid gaps and cracks in the system, Dr. Perez DOES NOT practice “no news is good news.” Our aim is to notify patients within 2-3 business days of their results and in most instances, this is done even on the same day. This maybe via e-mail through the patient portal or by phone.
While we strive to provide quality time with patients and the Doctor himself may run over his time slots, we do expect our patients to be on time for their appointment. If a patient is late by 15 mins or longer, we will have to reschedule the appointment and may charge a No Show Fee. The practice will also try to accommodate the patient but may have to reschedule as the last patient for that morning (or afternoon) in order to minimize time disruption and to be fair for other patients who are on time.
Patient vaccine records are available anytime on the patient portal. You may also reach out to us by email or phone call to request for a printout. We do participate in the San Diego Immunization Registry and transmit data regarding your vaccinations. You may also request your vaccine records directly through them.
Dr. Perez is board certified in Family Medicine. He has taken care of patients with a vast range of ages and conditions. He has taken care of pregnant patients, delivered babies, handled young ones (pediatrics) all the way to the young “once” (geriatrics). Our clinic is presently accepting patients 7 years old and over. We will consider accepting patients between 1-3 years old on a case to case basis.
We offer a personalized approach to patient care. Being a solo practice, our patients will always be seen by a Physician. We are proud to practice evidence-based medicine combined with a holistic approach in the face of these changing times, with the goal of facilitating optimal healthcare to our patients. We offer a broad array of services, including traditional family medicine to address today’s most common chronic conditions and non-emergency illness and injuries. We are also proud to be a certified BioTe provider for patient seeking alternative hormone optimization treatments. We look forward to offering more “niche” services to our patients in the coming near future. Stay tuned for that!
It is recommended for HMO patients to check who their assigned Primary Care Provider (PCP) is, which can typically be found on the front of their insurance cards. Patients can call their insurance customer service line to change their assigned PCP to Dr. Ronald Perez. This change usually takes effect on the 1st of the following month. My Family Doc accepts BOTH HMO and PPO insurance.
While we offer all necessary services in-house for the immigration exam (including labs and vaccines) at competitive rates, we do acknowledge the patient’s preference on where to get their labs and vaccines done. We require a maximum of 60 days for all requirements to be completed if the patient chooses to do labs and vaccines externally. We otherwise may charge a re-evaluation visit fee.
It is highly recommended for patients who receive “abnormal” lab results from the I-693 medical examination to return to our office for a re-evaluation by Dr. Perez. In this way, he would be able to review and discuss results, as well as determine what is medically necessary for patients going forward.
Dr. Perez has experience performing home visits. This service has been limited to a case to case basis and is on a concierge basis. We do not accept insurance for this service.
Yes. Covid vaccination is now required for patients 6mos and over.
CONTACT US
Open Mondays – Thurdays at 8:00am – 5:00pm
Open Fridays at 8:00am – 1:00pm
760-896-3030 | 760-896-3033
1207 Carlsbad Village Dr. Ste. A Carlsbad CA 92008
ALL KINDS
OF DIAGNOSTICS
All the services you need. One convenient location. My Family Doc has the Carlsbad’s most comprehensive medical and aesthetic services available.
OPENING HOURS
Mon–Thurs
8:00am–5:00pm
Friday
9:00am–1:00pm
OPENING HOURS
The following is for guidance only to help you plan your appointment with a preferred doctor or nurse. It does not guarantee availability as the doctors or nurses may sometimes be attending to other duties.
APPOINTMENTS
The first step towards a healthy life is to schedule an appointment. Please contact our office by phone or complete the appointment request form.
CONTACT US
Open Mondays – Thurdays at 8:00am – 5:00pm
Open Fridays at 8:00am – 1:00pm
760-896-3030 | 760-896-3033
1207 Carlsbad Village Dr. Ste. A Carlsbad CA 92008
OUR TEAM