720 North Tustin Avenue
Suite 104
Santa Ana, CA 92705-3606
Phone: (714) 565-1032
Fax: (714) 565-1035

Jeremy E. Kaslow, MD, FACP, FACAAI Physician and Surgeon
Board Certified Internal Medicine

NOTICE TO CONSUMERS
Medical Doctors are licensed and regulated by the Medical Board of California
(800) 633-2322
www.mbc.ca.gov

   Our practice is open to and welcomes new patients.  Although many individuals in our practice do not live near our office in Southern California, phone or Skype consultations with e-mail correspondence enable us to participate as a meaningful and significant partner for virtually anyone world-wide.

   Please print out a POTENTIAL PATIENT INTAKE PACK , complete it, and fax it back to our office at 714-565-1035 or send by e-mail to frontdesk@drkaslow.com along with all recent and pertinent laboratory or x-ray reports.  Included with this form is information about our office that you should review before submitting it.  Please send a copy of your Records Release Request to your doctors AND call their office to expedite getting your medical records forwarded to our office.  We will also need a copy of the Records Release Request in case you need help in getting the records to our office.  Dr. Kaslow will review your information and prioritize your consultation.  We may request that you complete additional information or forms before we agree to participate in your care.  You may want to look at our office policies and a list of our fees first.

   Please recognize that our practice is not meant to be all things to all people and that choosing each other is a mutual decision.  From the profile you send us, we may determine that you are not a good candidate for our approach to health care.  On the other hand, if we are a good match for each other, when the office has set up your appointment, please expedite getting all intake forms and medical records to us as soon possible.

   We remain participating providers in the Cigna PPO network.

   We are not in-network for Blue Cross, HealthNet, Aetna, One Health Plan, Mega Health, Blue Shield, Pacificare, United Health Care or Choice Care.  This basically means that your insurance company will be billed as a courtesy to you, but you are responsible for the entire amount of your bill.  Most insurance companies cover a portion of your care depending on the plan.  We can not and do not bill Medicare or Medi-Cal under any circumstances.  We want this to be clear in the beginning so it does not interfere with the healing relationship.

Thank you for your interest.

Jeremy E. Kaslow, M.D., F.A.C.P., F.A.C.A.A.I.

Susan Kaefer, R.P.T.

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