For Patients

In Preparation

In order to become a new patient of the UCSF Fresno Alzheimer & Memory Center please consider the following:

  • If you have an HMO, we will need a prior authorization from your primary care doctor’s office before a patient is accepted. Please make sure they include a total of 6 visits on the authorization form. Please note the AMC is not contracted with all HMO carriers.
  • If you are being referred by a physician, please have the physician’s office send us a referral form and medical records or refer to us in the EPIC system
  • Office visits will not be scheduled until the patient packet is completed and returned to our Center.  The patient packet needs to be completed by a designated primary caregiver/collateral informant. This packet, when complete, will provide a great deal of information about the patient to the AMC team.

Note: Because memory loss and other related symptoms are often complex, input from a patient’s spouse, family, caregiver or collateral informant is vital to the evaluation process.

 

Patient forms can be completed either via 1) our secure online portal (portal link sent by our staff to patient/family email upon verbal authorization) 2) printed and faxed back to (559) 227-4167 or 3) mailed directly to UCSF Fresno Alzheimer & Memory Center, 550 E Shaw Ave., Ste 105, Fresno, CA 93710.

Some patients, for their convenience, ask whether they may submit the patient packet by email. While this is not as secure as other methods of submitting private medical information, we can accommodate these requests on a case-by-case basis. Please let us know if you wish to submit your information this way​.

 

Ojo: No todas las formas en este paquete se encuentran en español, si usted necesita ayuda llenando las formas que se encuentran en inglés, por favor llame a nuestro centro y pregunte por Andrés, él les podrá ayudar a resolver cualquier pregunta.

Por favor imprima el paquete, llene las formas y mándelas por correo a nuestra oficina, 550 E Shaw Ave.,  Ste 105, Fresno, CA 93710. Una vez que las recibimos completas le podremos dar una cita. Muchas gracias.

Patient referrals will be reviewed by clinical staff to determine suitability for services provided at our Center.

 

OPEN PAYMENT DATABASE NOTICE FOR PATIENTS:

The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services (CMS) Open Payments web page is provided here: https://openpaymentsdata.cms.gov. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public.