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General Intake Forms

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HIPAA Privacy of Notice Short*

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HIPAA Privacy of Notice Full

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Patient Agreement Form*

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Medical Records Release Form

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Financial Policy Form*

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Patient Registration Form*​​

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* These forms are required for new patients to fill out. 

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​Sleep Disorders
Lifestyle Guidance
Sexual Transmitted Diseases
Primary Care

8:30 AM - 5:30 PM

8:30 AM - 5:30 PM

8:30 AM - 5:30 PM

8:30 AM - 5:30 PM

8:30 AM - 5:30 PM

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420 North Garfield Avenue

Suite 203

Monterey Park, CA

91754​

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626-763-1899

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626-547-4438

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Hours of Operation

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Monday

Tuesday

Wednesday

Thursday
Friday

 

Lunch Break

Holiday hours may vary, please contact us for details.

12:30 PM - 1:30 PM

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© 2024 by General Sleep Group. Harrison Medical is owned and operated by Harrison Hasanuddin, DO, Inc. 

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