Patients

Pendleton Family Medicine Forms & Policies

We have an automated check-in system that includes pre-registration! Please call and ensure your current email address is on file with us. Up to 72 hours prior to your scheduled appointment, you will receive an email or text with a pre-registration link that enables you to fill out all our forms online! If you’d still like to do your forms on paper, download below.

Billing & Insurance

Billing Phone: 877-708-1119
Billing Address:
Pendleton Family Medicine
P.O. Box 102799
Pasadena, CA 91189-2799
Make a Payment: Make a payment online

    FAQ

    Q: What is a Physician Assistant or PA-C?

    A: A physician assistant works under a physician’s license, who is called their supervising physician. They go to graduate school, attend many of the same courses as students in medical school and are able to order labs, diagnostic testing, write prescriptions and perform minor procedures. Physician assistants may be considered your primary care provider, and can also work specialties or in hospital settings. Sometimes if your doctor is unable to see you, you may be scheduled with a physician assistant to evaluate you instead as they are very capable of caring for you and your family. Our physicians and physician assistants have close relationships to ensure you receive the best possible care.

    Q: What is a Nurse Practitioner?

    A: A Nurse Practitioner are often Registered Nurses who have chosen to continue their education in order to provide higher-level care for their patients. They go to graduate school, attend many of the same courses as students in medical school and are able to order labs, diagnostic testing, write prescriptions and perform minor procedures. Nurse Practitioners may be considered your primary care provider, and can also work specialties or in hospital settings. Sometimes if your doctor is unable to see you, you may be scheduled with a nurse practitioner to evaluate you instead as they are very capable of caring for you and your family. Our physicians, nurse practitioners, and physician assistants have close relationships to ensure you receive the best possible care.

    Q: What is a Care Team?

    A: Our Care Teams consist of everyone from the patient, medical receptionists and referrals coordinator, to your medical assistant or nurse, and your provider [doctor, physician assistant, or nurse practitioner]. Care Teams may also include others such as pharmacists, community resources, and specialist providers. Together, they all work to facilitate timely care.

    Q: What is a Patient-Centered Primary Care Home [PCPCH], or Medical Home?

    A: PCPCH is a model or philosophy of primary care that consists of 5 attributes: Patient Centered, Comprehensive, Team-based, Coordinated, Accessible, and Focused on Quality & Patient Safety. This ensures that the patient is included in their medical care. Any clinic participating in PCPCH is striving for excellence and has adapted these attributes and implemented them to fit their own unique characteristics.

    Q: I want to become a new patient. What do I do?

    A: Please call our office at the main number, 541-276-1700 for more information!

    Q: I want someone else to be able to talk to my care team about me and my medical records. What do I do?

    A: You would sign a simple release form listing who you would like to have access to your records. This can be revoked in writing at any time.

    Q: I have Power of Attorney, legal guardianship, sole custody, other legal representation of a patient at your clinic. What do I do?

    A: Bring in a copy (does not have to be the original) of a notarized current Power of Attorney or other form so that we can place in the patient’s chart.

    Q: Are you currently accepting patients with my insurance?

    A: Please call our office and we will do our best to help you get the care you deserve.

    Q: What is the difference between my co-pay, co-insurance, and deductible?

    A: Co-pay is a set amount you pay whenever you use a particular service, such as a visit to your primary care. This amount does not change or depend on co-insurance or deductible. It is a contracted amount between your insurance and your provider and is required each and every visit. Co-insurance is an amount split between you and your insurance company that you have to pay until you met your plan’s maximum out of pocket for the year. For example, you have a 25% co-insurance on an X-Ray. You would pay 25% of the total cost, and insurance picks up the remaining 75%. Deductible is a fixed amount you have to pay each year toward cost of your healthcare before your insurance picks up and begins to pay fully. Medicare plans may be different.