About Your Visit - What you need to know?

Dr. Cockerham and her staff are committed to providing personalized care within a relaxing environment. Once you contact our office, we will respond and confirm your appointment at least two days before by phone. Our trained staff will make every effort to smoothly facilitate your ongoing relationship with Dr. Cockerham and our office.

Please let us know if you have unmet needs: dr@CockerhamMD.com.

We make every effort to be punctual. But you should allow one and a half hour for your initial comprehensive visit. We do not want to rush you and your care. Do give us your cell phone so we can call or text you if the schedule is altered. We have magazines; but please bring your smart phone, computer or book to entertain yourself just in case the complex medical issues of another patient slow our flow.
Please bring:

• Your insurance card and driver’s license
  
• Your doctors’ contact information (business cards are ideal)
  
• Actual MRI/ CT scan on CD and report
  
• Recent lab results and reports from other doctors
  
• A list of your medications and allergies
  
• If you wear contact lenses, bring your glasses and a contact lens case.
  
• A friend or family member if English is a second language or to drive you home if you are not comfortable driving with your eyes dilated.

Medical Forms: Please arrive 20 minutes early to fill out forms.....or better yet, Click on the Medical Web Office Icon to:

• Pre-register for your appointment
  
• Download & print all patient forms including your health history
  
• Medical records release
  
• Pre/post-op procedure instructions
  
• Request an appointment or prescription refill

For billing questions or concerns, call: toll free 877-559-9150. We accept most PPO’s, Medicare, and very few HMO’S. For a list of accepted insurers “click here” HMO patients will need to get a prior authorization for new patient consult.

We look forward to meeting you, Kimberly Cockerham, MD & staff
www.CalEyes.com; office: 650-559-9150, fax: 650-559-9151

New Patient Forms Patient Registration Patient Profile Form Patient Medical History Medical Records Release Summary of Privacy Policy Cancellation Policy Payment and Insurance Policy

Other Forms Acknowledgement of Responsibility of Payment Certificate of Need Pre-Anesthesia Questionnaire Consent for Orbital Tumor Removal Your Skin Space self-sign up sheet

Pre & Post Operative Instructions

Medications to Avoid Before Surgery and Medications that contain Aspirin
Oculoplastics Post Operative Instructions
Eyelid Surgery Pre-Post Operative Instructions
Strabmisbus Surgery Pre-Post Operative Instructions
Orbital Surgery Pre-Post Operative Instructions
Post Operative Instructions for Dacrocystorhinostomy (DCR)
Pre-Treatment Instructions Active, Max, Total, Deep FX,

For Physicians

Physician Patient Referral Form
Physician Referral for Medical Services

Participating Insurance Plans

Aetna PPO Blue Shield PPO of CA Blue Cross PPO of CA Beech Street Cigna / Great West Corval First Health / Coventry Great West Guardian

Hill Physicians Humana Choice Care Health Net Interplan Network Medicare Multiplan/PHCS Sutter IPA Tricare United Healthcare USA MCO

Physician’s Medical Group (PMG)		Preferred Physicians Medical Group (PPMG)
Aetna	HMO	Affordable Health Care (AHC)	PPO
Aetna	POS	Admar	PPO
Blue Shield	HMO	BCE Healthcare	PPO
Blue Shield	POS	Beech Street	PPO
California Care	HMO	Choicecare	PPO
California Care	POS	Formost	PPO
Cigna	HMO	HMN	PPO
Cigna	POS	Health Network	PPO
Cigna (Open Access)	POS	MedNetwork	PPO
Coastal HC Admin	PPO/EPO	Multiplan	PPO
Health Net	HMO	Private Health Care Service	PPO
Health Net	POS	Pro-America	PPO
Health Net	PPO	USA MCO	PPO
Health Net Seniority Plus	HMO	Up & Up	PPO
Great West	HMO
Pacificare	HMO
Pacificare	POS
Secure Horizons	HMO

We do have an agreement with Palo Alto Medical Foundation (PAMF) to see their Neuro-Ophthalmology patients. This includes patients that are participating in Camino Medical Group, Palo Alto Medical Clinic, Santa Cruz Medical Clinic and Palomares. Patients should still get an authorization to see Dr. Cockerham.

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