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    CARDIOLOGY                    PRACTICE
                             FAMILY                          MEDICINE
                                                      INTERNAL                  INTERNALMEDICINE
    Henryp. GongMD FACC     Siamak Elyasi
                                        MD             PULMONARY
                                                             Del
                                                       Gerald Rio MD                   ZhangMD
                                                                                Wen-Gang
                                                                 Hsu
                                                       Hsien-Wen MD


               2220 Gladstone
                            Drive,Suite 3   PittsburgCA 94565-5123 (925) 432-3318 FAX(925) 423-7L25
                3720
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DearNewPatient:

Ourofficewouldliketo welcome   youas a patient Springhill
                                               to          MedicalGroup.         you
                                                                        Enclosed will find a
           form. Please
registration           brin$this completed                        cardto yourfirst appointment.
                                            form and your insurance
We appreciate yourearlyarrivalto allowtime for processing
                                                        yourrecords.

Officehoursand officelocations:
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
        office. Thedoctorshavescheduled
Pittsburg                                                                       so
                                           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
                                                                                          are
up by a answering serviceand givento the doctoron call who is available emergencies.
                                                                      for              Pleasedefer
routinecalls,callsfor appointments,callsregardingbillingand prescriptionrefill requests regular
                                                                                      to
office hours.

Appointments: Appointments   must be made in advance,however yourconditionis urgent, will
                                                             if                      we
make everyeffortto schedule you the same day. You must notifyus of cancellations least24 hoursin
                                                                               at
advanceand if you are more than 15 minuteslatefor an appointment you may haveto wait or be
          to
rescheduled anotherday.

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
                    to                                   but
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
                                                              a
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
                                                          Our
careand courteous         Phonecallsare carefully
                   service.                                  to
                                                  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
                                        or
medicalcondition  pleaselet the receptionist
                                           knowand the doctoror his,/hermedicalassistant  will
response soonas possible.
         as

We welcomeyouto our practiceand look forwardto servingyourhealthcare needs.

Sincerely,

TheStaffand Physicians Springhill
                     of              Group
                               Medical

				
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