Forms & Payment

Accepts new patients

Medicare Medicaid Workers' compensation Other
Yes No No Yes

Medical insurance plans and payment options

MELVIN M.K.W. HAYASHI M.D.: Medicare

DWITE D. DAHMS M.D.: Blue Shield PPO, Medicare

GARY PATTEE M.D.: Blue Cross PPO, Blue Shield PPO, Medicare

PIERRE DURAND, JR. M.D.: Aetna PPO, Blue Cross PPO, Blue Shield PPO, Cigna PPO, Medicare

MICHAEL T. VERCILLO M.D.: Aetna PPO, Blue Cross PPO, Blue Shield PPO, Cigna PPO, HealthNet PPO, United Healthcare PPO

HIPAA Policy

HIPAA Notice of Privacy Practices

Office information from HAYASHI, DAHMS, DURAND,PATTEE, & VERCILLO

Infomedical History Form (For Dr. Durand)

Infomedical History Form (For Drs. Hayashi and Dahms)

Patient Registration Form

Shoulder History Form (For Dr. Pattee)

Summary of Financial Policy

Contact Information

HAYASHI, DAHMS, DURAND, PATTEE, & VERCILLO 375 Rolling Oaks Dr., Suite 200 Thousand Oaks, CA USA 91361 View map Phone 805-497-9481 Fax 805-497-3416

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