Coastal Cardiology is currently accepting new patients. We work with a variety of local and nationwide insurance plans. If you would like to learn more about scheduling a consultation with one of our physicians, or are an established or scheduled patient with any questions, please contact us by phone at 805-782-8844.
Each of the forms shown below is available as a PDF or Portable Document Format. If you have difficulty viewing or printing these documents, please consider updating your PDF viewer by clicking here or call our office and we would be happy to fax or mail the forms you require.
- New Patient Packet / Paquete para Nuevos Pacientes
- Patient Registration Form / Formulario de Registro de Pacientes
- Health History Form / Historia de Salud
- Financial Policy/ Política Financiera
- Nondiscrimination Notice / Aviso de No Discriminación
- Medical Records Release / Divulgación de Archivos Médicos
CardioSmart is an educational site created by the American College of Cardiology. This unbiased, ad-free resource provides videos describing common diagnoses and frequent treatments, details on upcoming community events and personalized support for smoking cessation, weight management and other facets of cardiac disease prevention and management.
Coastal Cardiology is happy to work with a number of insurance providers, including Medicare, Blue Cross, Blue Shield, Humana, HealthNet and Tricare. Coastal Cardiology does not accept Worker’s Compensation. Coastal Cardiology is not a preferred provider for UnitedHealthcare. Please contact our Business Office at 805-782-8844 x509 with any specific questions regarding insurances accepted by Coastal Cardiology providers.
Forms & Records
As a specialist practice, we are not always the appropriate provider to complete forms such as Family Medical Leave Act (FMLA) and disability forms. In many circumstances, your primary care provider may be a better fit. Prior approval from your physician is required before a form is submitted to our office. We welcome phone calls to clarify this policy.
- There is a fee of $25.00 to complete either FMLA or disability forms. If we determine we are not the best provider to complete these forms, any payments made for this service will be returned.
- There is anticipated turnaround time of 10 business days from receipt of the Request Form and payment.
- Forms and payment may be submitted to the receptionists at any of Coastal Cardiology’s offices.
- Alternatively, you may choose to use the digital form shown below, submit your payment online (look for the Make a Payment button at the bottom left corner of this page) and email a completed signed version. Please note email is unsecured and there is some level of risk your personal information could be read or otherwise accessed by a third party while in transit. Any use of email to firstname.lastname@example.org will be viewed as your informed consent to any associated risk.
- Click here to view the Forms Request / Solicitud de formularios
Outgoing Records Requests
Coastal Cardiology processes outbound medical records requests for other healthcare providers, the patient’s own reference and from third parties such as insurance companies.
- For records to be sent to another healthcare provider, there is no charge and the turnaround time is 2 business days.
- If you would like to request records for your own use, there is a fee of $25.00 and the turnaround time is 2 business days.
- Third party requests for information may have variable charges and turnaround time, dependent upon the nature and volume of the request.
- Click here to view the Medical Records Release / Divulgación de Archivos Médicos
Please begin your request by submitting a completed signed Records Release and, depending upon the request type, payment. This may be done in person at any of Coastal Cardiology’s offices, via fax to 805-782-8859, by mail to 1941 Johnson Ave Ste 101, San Luis Obispo, CA 93401 or via email with online payment (look for the Make a Payment button at the bottom left corner of this page). Please note email is unsecured and there is some level of risk your personal information could be read or otherwise accessed by a third party while in transit. Any use of email to email@example.com will be viewed as your informed consent to any associated risk.
Form Downloads in PDF format
Each of the forms shown below is available as a PDF or Portable Document Format. If you have difficulty viewing or printing these documents, please consider updating your PDF viewer by clicking here or call our office and we would be happy to send you the forms you require.
Coastal Cardiology now offers the ability to make a payment from our website. To submit a payment, simply select the “Make a Payment” link at the very top of the web site. This will take you to a secure payment form. You will need your customer ID, or account number, to complete the process. This number can be found on any statement, via the Portal or by calling our office. Please note we accept Visa, MasterCard, AMEX and Discover. Before clicking submit at the bottom of the page, remember to enter the security code (CVV) to verify your payment. Please let us know if you have any questions or comments about this quick, convenient and secure service.
Through the Portal, patients can access parts of their medical record and securely communicate with our office. Review lab results or refill medications anywhere you have internet access. Coastal Cardiology also supports use of the Healow app, available through the App Store and Google Play, to bring the Portal to your smart phone or tablet. If you have additional questions or would like to set up a Portal account, please call our office.Click here to link to the Patient Portal. To learn more about the Portal and Healow, please watch the videos below.