Patient Information
  • Patient Information

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  • Medical Records Request

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  • Clinic Policies Acknowledgement

  • Summary of Key Clinic Policies:

    • Payment is due before your visit. You may inquire about payment plans. Insurance deductibles must be met before coverage begins.
    • No-shows and late cancellations will incur fees and may result in dismissal from the practice.
    • Medication refills and questions require scheduled visits. This helps maintain patient safety and documentation integrity.
    • Controlled substances are not guaranteed and may require drug testing and monthly follow-up if approved.
    • The clinic operates strictly as a primary care clinic and does not provide urgent or emergency care services.

    Grievance and Complaints Process:
    We value your feedback. If you have concerns or complaints about the care you receive, you may contact our clinic administrator in person or by calling 559-369-7787. All grievances will be addressed within 10 business days.

     

    Consent to Communication:
    By signing below, I consent to receiving communications regarding my care via phone, voicemail, SMS, or email. I understand that The Modern Medicine Group does not use online messaging portals like MyChart and requires appointments for direct clinical interactions.

    Consent to Care:
    I understand and agree to abide by all clinic policies as outlined. I consent to be treated by The Modern Medicine Group and understand that clinic policies may be updated from time to time.

     

    Read Full Policy PDF

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  • HIPAA & Communication Preferences

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  • Health Questionnaires

  • PHQ-9 (Patient Health Questionnaire-9)

  • GAD-7 (Generalized Anxiety Disorder-7)

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  • If you need help completing forms, call:  559-369-7787

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