Terry C. Lin D.O., INC.

New Patient Information

Once you have scheduled an appointment with our office, please download the forms below, fill them out legibly and bring them with you to your initial consultation along with your insurance cards and a photo ID. Please note that if you have a co-pay it is due at the time of your visit. We accept the following forms of payment: ATM, money orders,

If you are unable to download the forms below please arrive a few minutes prior to your appointment time to fill out your new patient paperwork

We are currently accepting new patients and are contracted with most insurance companies. However, it is Patient responsibility to call your insurance company in advance to be sure we are a contracted provider within your plan, and that there is no referral required by your primary physician.

New Patient Forms:

Patient Registration Form
Health Questionnaire

Terry C. Lin D.O., Inc

  • Address: 2516 Samaritan Drive Suite M San Jose, CA 95124
  • Phone: (408)358-6580
  • Fax: (408)358-6515
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