Patient Forms

These new patient forms are required to be completed before seeing Dr Hooper. For your convenience, we have provided these forms online that can be pre-filled with your information. After you complete the forms, you can print them out, sign and bring them to your visit or send them via fax to 760-684-8583. Any forms or patient health information can also be sent to us securely at: rsmg@myupdox.com.

***Please note that information sent to either this fax number or email address is HIPAA compliant and therefore, secure. We are attempting to provide secure and private means for patients to provide us with Patient Health Information (PHI) that meets those needs. In addition, once you are an established patient in our medical office you can sign up to authorize a secure and private Patient Portal to communicate to our office in a secure manner.

For your protection, please do NOT email this personal health information to any Provider’s personal email address.

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Patient Registration Forms: