Henryp. GongMD FACC Siamak Elyasi
Gerald Rio MD ZhangMD
Drive,Suite 3 PittsburgCA 94565-5123 (925) 432-3318 FAX(925) 423-7L25
Ourofficewouldliketo welcome youas a patient Springhill
to MedicalGroup. you
Enclosed will find a
registration brin$this completed cardto yourfirst appointment.
form and your insurance
We appreciate yourearlyarrivalto allowtime for processing
We havetwo officelocations listedat the top of this letter. Our regular
officehoursare 8:30 am to 5:3O
pm, Monday We
throughFriday. are alsoopenfor urgentcareon Saturday from 9 am to 1pm in our
daysin the differentofficelocations let our staff know
whichofficeyouwouldlike to visitwhenyou make an appointment.
After hourscalls: Whenour officeis not openour main phonelines(432-3318and 779-96OL) picked
up by a answering serviceand givento the doctoron call who is available emergencies.
routinecalls,callsfor appointments,callsregardingbillingand prescriptionrefill requests regular
Appointments: Appointments must be made in advance,however yourconditionis urgent, will
make everyeffortto schedule you the same day. You must notifyus of cancellations least24 hoursin
advanceand if you are more than 15 minuteslatefor an appointment you may haveto wait or be
Payment and billin8: Copays co-insurance deductibles known,are payable the time of service.
, and if at
We offera discount patientswho do not haveinsurance paymentmust be made in full at the time
of service.Bringa copyof your healthinsurance cardto eachvisitand notifyour officeof any changes in
youraddress, phoneor insurance informatign. Payment can be madeby Visa,Master0ard, Discover,
AmericanExpress, cashor check.Returned checksare assessed $30 fee. lf you do not payyour
outstanding balance youraccountmay be sentto an outside collectionagencyand additional chargesin
the form of interestand handlingfees will be addedto youraccountbalance.lf you havequestions about
youraccount wouldlike to set up a paymentplan please
or ask to speakto our business officestaff.
Ourofficeis staffedwith well trainedmedicalprofessionals. goalis to providehish qualitymedical
careand courteous Phonecallsare carefully
evaluated ensureaccurate and efficienthandling
of yourimportantquestions and concerns. Everyeffortwill be madeto returnyourcall promptly. Your
doctormay not be available immediately may be at the hospital. lf you call is aboutan urgent
medicalcondition pleaselet the receptionist
knowand the doctoror his,/hermedicalassistant will
response soonas possible.
We welcomeyouto our practiceand look forwardto servingyourhealthcare needs.
TheStaffand Physicians Springhill