Initial Intake Forms

Please print and fill out the Initial Intake Forms prior to your first visit.  You may scan and email the forms directly to OCTchiro@gmail.com or bring them in on your first visit.  If your case involves a motor vehicle accident, please also print and fill out the Auto Accident Forms in addition to the Initial Intake Forms.  To expedite verification of your insurance, please email a copy of your insurance card and driver's license to OCTchiro@gmail.com or text a picture of both to (562) 999-2829.

Initial Intake Forms
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Auto Accident Forms
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Book your appointment today!

(562) 999-2829

17906 Pioneer Blvd, Suite 102
Artesia, CA 90701
(Across the street from 99 Ranch Plaza)