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Superior Physical Medicine
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New Patient Forms

Below you can download the intake forms for becoming a Superior Physical Medicine patient.

  • You will need AdobeReader® to view the intake forms they are PDF files.
  • Should you not have AcrobatReader® Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Bring it with you to your appointment or simply fax them to 714-692-7141 at your convienance.

New Patient Welcome Packet

Download

Personal Injury History Form

Download

In the above links, you will find documents which will help you adjust and orient yourself as you become a trusting and respected patient of Dr. Kevin Shaevitz and the team here at Superior Physical Medicine. Part of what we do, and arguably part of why we do it better, is that we make all of our practice decisions in a way that affects our patients positively. In essence, we put YOU first.

Why Would We Do That?

It would seem like Superior Physical Medicine, like many of its competitors, would run like a business. We are a business, of course. We make money, pay our staff, and pay our bills, all because people purchase the service we provide. However, we do not operate like a business when it comes to our patients. We do not treat you like customers or clients. We treat you like family.

We are committed to wellness. Part of wellness is the comfort and happiness that comes from being considered throughout the process. We hope you appreciate that, because it will always be our uppermost priority here at Superior Physical Medicine.

“Everyone here is so caring, and makes you feel like family. Whatever it takes to take care of their patients, is exactly what gets done at Superior. I wouldn't go anywhere else.”

WE ARE HERE FOR YOU!

Superior Physical Medicine

22224 La Palma Avenue Suite A

Yorba Linda, CA 92887

(714) 692-7139

Pain Management Physician

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OFFICE HOURS
Mon. 8am - 12pm, 2pm - 6pm
Tue.Closed
Wed.8am - 12pm, 2pm - 6pm
Thu.1pm - 6pm
Fri.8am - 12pm
Sat.8am - 12pm
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