Advanced Perinatology
New Patient Intake · PPO & Self-Pay
REQUEST YOUR FIRST VISIT

Request your first visit online.

If you have a PPO plan or you are paying on your own, you can request your first visit with us directly, and our team will call you to schedule it. No referral needed, and the whole form takes about two minutes.

Request my visit → Watch how it works
A short walkthrough. Every step, shown with a sample patient.
TWO SIMPLE STEPS · ABOUT 2 MINUTES

What you will fill out

1
About you
Your name, date of birth, cell, and email. Your age fills in on its own, and the email is where your patient portal invitation will go.
2
Coverage and your visit
Tell us how you will be paying, choose what you would like to be seen for, add your due date if you know it, and pick the office that is easiest for you.
BEFORE YOU START

Have these handy

Your insurance card, if you have one
Your due date, if you know it
Your phone number and email
The name of any doctor who referred you (optional)
WHICH APPLIES TO YOU

Three ways to be seen

PPO insurance
Request directly
No referral or authorization needed. Pick your plan, enter your member ID, and we bill your plan directly.
Self-pay
Request directly
Simple, transparent cash pricing. We review the exact cost with you before your visit. No surprises.
HMO insurance
One extra step
HMO visits need a referral from your OB first. Ask your OB office to send one to us, and we will take it from there.
OUR LOCATIONS

Pick the office that is easiest for you

Pasadena Burbank Downtown LA Lancaster Beverly Hills
You choose your location right in the form, and your request goes straight to that office.
COMMON QUESTIONS

Quick answers

Do I need a referral?

Not if you have a PPO plan or you are paying on your own. If you have an HMO plan, your OB office needs to send us a referral first.

What does it cost if I pay on my own?

We offer transparent cash pricing and will go over the exact cost with you before your visit, so there are no surprises.

What if I do not know my due date yet?

That is fine. The due date is optional. Leave it blank and we will sort out dating at your visit.

What happens after I submit?

You will see a confirmation number on screen, our team will call you to schedule, and your patient portal invitation will arrive by email.

Ready when you are.
Requesting your first visit takes about two minutes.
Request my visit →
Advanced Perinatology · Pasadena · Burbank · Downtown LA · Lancaster · Beverly Hills advancedperinatology.com