OUR LOCATIONS

IRVINE OFFICE:
14150 Culver Drive, Ste 103
Irvine, CA 92604


 

(949) 262-9142

RANCHO SANTA MARGARITA OFFICE:

23121 Antonio Pkwy, Ste 100

RSM, CA 92688

(949) 713-6445

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NEW PATIENT FORMS

Prepare for your first visit as part of the Envision Sport family.

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For your first appointment, please bring your photo ID, insurance card, physical therapy prescription (if you have one), and a change of clothes (something that you would typically work out in).

Our goal is to make the new patient process as simple as possible! For your convenience, we have also made our patient intake forms available to be completed from home prior to arriving at Envision Sport for your first appointment. If you are unable to print them - don't worry! We'll have them available for you when you arrive.

Please note: All patient responsibilities including co-pays, co-insurances, & deductibles are due at the time services are rendered.

PATIENT INTAKE

Coming to us as a PPO Patient?
Click to download

MEDICARE

Coming to us as a Medicare Patient?

Click to download

WORKER'S COMP

Coming to us as a Worker's Compensation Patient?

Click to download

HIPAA

Want to see our Privacy Policy?

Click to download

The following insurance companies require additional forms to be completed: Cigna, United Healthcare, & Medicare
Please allow 10-15 minutes before your first appointment to complete the additional forms. 

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