Registration Forms

If you are a new patient or need to request medical records from another provider, save time by downloading these forms before your appointment.

New Patient Forms (Enlgish) (pdf)


New Patient Forms (Spanish) (pdf)


Medical Record Release Form (pdf)


General Office Policies

Appointments: We see patients BY APPOINTMENT ONLY. Same-Day appointments are usually available for urgent or sudden illness but please call first. We may be able to accommodate walk-ins, but you will be subject to your urgent care copay or deductible. (See Financial Policy #1 for more details!) If our office has already filled up, we will refer you to Covina Urgent Care. Our Covina Urgent Care operates on a walk-in basis.

Cancellations: Please call 24 hours in advance if you are unable to keep your appointment. This allows us enough time to fill the slot with a patient who really needs it. If an appointment is not cancelled 24 hours in advance, the patient will be subject to a No Show/ Missed Appointment Fee, $20 / $40. (See Financial Policy #7 for more details!)

Running On Time: We know that your time is valuable, that is why we try our best to run on schedule. We ask that you please do the same by being on time for your appointment. Please keep in mind that we are running several different schedules, so if someone who arrived after you is called before you, please be aware that he/she may be seeing another provider.

Test Results: If you have had a diagnostic test done (labs, x-rays, ultrasound, etc.) please schedule a follow-up appointment within 7-10 days to go over the results with your provider. Results will not be given over the phone, unless told otherwise.

Prescriptions and Refills: Refill requests require the approval of a provider and can take up to 72 hours (3 business days) to be processed.

  • The time to ask for a new prescription or a prescription refill is DURING your appointment.
  • Please do not wait until you have run out of you medication(s) to request for a refill.ย 
  • Many medications must be monitored for efficacy and potential side effects. We require check-ups every 3-4 months for these medications. Please be sure to keep these appointments or your medications will not be refilled.

Narcotics & Controlled Medications: We do not prescribe narcotics or controlled medications. If you feel as though these medications are necessary, we can refer you to a pain management specialist.

Auto Accidents: If your injury was caused by a motor vehicle accident, we cannot see you at Castellanos Family Practice. Motor Vehicle Accident visits are performed at our Covina Urgent Care office. Please ask anyone at the family practice for more details.

Workerโ€™s Compensation: If your injury was caused by an accident in your workplace, we are not authorized to treat you at Castellanos Family Practice. We may be able to treat you at Covina Urgent Care. Please contact your work supervisor for further instructions.