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Filling out these forms ahead of time will help save time when you come for your appointment. All the forms below are available in Adobe PDF format.
 
If you haven't installed Acrobat® Reader® on your computer, in order to view and print these forms, please download and install the Acrobat Reader from the Adobe website.
 
New Patient Info
 
Health Questionnaire
 
Spanish Forms - Formas españolas
 
Nuevo Cuestionario del Paciente
 
Información del Paciente
 

 

Insurance


We accept all major PPOs, POS and EPO plans.
We accept Santa Clara Family Health Plan,Healthy Kids, Healthy Families and Medical.
We are a member of Physicians Medical Group of San Jose.
If you have any questions regarding your health plan acceptance, please call our office.
 

 

Payments


We accept cash, check or credit cards (Visa and Master card only) for our services. If you are covered by insurance, we will bill your insurance company.
 
Billing
 
Our billing is done by Med Account Services. For any billing questions, please call Med Account at (925) 484-1395.
 

 

Languages:


English, Spanish, Tamil, Kannada, Telugu, and Malayalam
 

 

Office Hours:


Monday to Friday
 
9 am to 12 noon
2 pm to 5 pm.
 
Our offices are closed on weekends.
 

 

Contact Us


Address:
155 North Jackson Ave. Suite 101
San Jose
CA 95116
 
Phone:
(408) 259-1250
 
Map/Directions
Click for Google Maps
 

 
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Copyright © 2010, Dr. Amara Balakrishnan, All rights reserved. 
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