Forms & Documents

Listed below are commonly used forms for our office.  Please mail these forms one week prior to your appointment to:
Roy Medical Associates, Inc.
5601 Norris Canyon Road, Suite 340
San Ramon, CA 94583

Or send them via FAX at least 24 hours prior to your appointment to: 
(925) 866-8082

You may also bring them with you at the time of your appointment 

Patient Registration

All new patients to Roy Medical Associates, Inc. must complete this form.

Office and Financial Policies

These are our current Office and Financial Policies. Please review them; all patients sign on the registration form that they have read, acknowledge, and agree to these policies. Commonly referred to as the HIPAA notice, as required by the Health Insurance Portability and Accountability Act. 

Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review carefully. 

Records Release

​If we require records from your former physician, you will be asked to complete a Records Release form at your next visit. If you would like copies of your records due to a physician transfer or for your personal records, please refer to the Medical Records page on this website for the current fees and policies associated with records requests.