San Bernardino:
Clinic Hours:
Mon - Fri 8:30 AM - 5:00 PM
Phone:
Email:
sanbernardino@sonus.com
Address:
399 East Highland Ave., Suite 117
San Bernardino CA, 92404

Patient Information:
First Name:
Last Name:
Date of Birth:
Phone:
Phone Type:
New Patient:

Please complete the following sections to create your patient record.



Email:

Home Address:
Address:
City:
State:
Zip Code:
Insurance:
Carrier:
Policy/Group #:

Do you have a Referral or Authorization:
How did you hear about us:
Other:

Additional information for your appointment:
Please contact your clinic at to reschedule or cancel an appointment.
This is a secure site, your personal information will not be shared.