Patient Forms | Dr. Lalezari Internal Medicine LA

Complete your forms securely and conveniently before your visit to help streamline your care.

Preparing for Your Appointment

To ensure a smooth and efficient visit, Dr. Lalezari’s practice offers secure online forms that can be completed prior to your appointment. Completing forms in advance helps reduce wait times and allows your physician to better prepare for your care.

All forms are reviewed confidentially and securely.

Available Patient Forms

Please select the appropriate form based on your visit type:

New Patient Form

For individuals visiting our practice for the first time. This form helps us understand your medical history, current medications, and health concerns.

Physician Orders for Life-Sustaining Treatment (POLST)

Official medical orders for seriously ill people. It lets patients choose the exact life-sustaining treatments they want and works immediately in an emergency.

Annual Physical Form

Designed for patients scheduled for annual physical exams to help streamline preventive care, labs, and screening discussions.

Advance Care Directives

Advance care planning documents allow you to communicate your healthcare preferences clearly and proactively.

Home Sleep Study Form

Complete this form to request a Home Sleep Study with Noble Physicians Medical Group. Includes patient information, consent, and payment authorization required to schedule the study and review results with a provider.

IV Fluids & Hydration Form

Use this form to select IV hydration or infusion services offered by Noble Physicians Medical Group. Includes patient information, treatment selection, consent, and payment authorization for mobile IV therapy services.

Secure & Confidential Submission

All patient forms are submitted through a secure system that protects your personal and medical information. If you have questions while completing a form, our office staff is available to assist you.

Need Help With Forms?

If you are unable to complete forms online or have questions about which form to use, please contact our office.

(323) 765-1500

Info@doctorlalezari.com

Day-of-Visit Reminder

Completing your forms ahead of time helps ensure:

Shorter check-in times
More focused time with your physician
Accurate and up-to-date medical records

We encourage all patients to submit forms prior to their appointment whenever possible.

What Our Patients Say

Dr. Lalezari is incredibly thorough and patient. He took the time to explain my results and made sure all my questions were answered. I finally feel like I have a doctor who actually listens.

Maria G.

I used the house call service for my elderly parent, and it was exceptional. The visit was prompt, compassionate, and comprehensive—truly hospital-level care at home

Luis M.

The staff is friendly and welcoming, and the doctor really takes time with you. I never feel rushed, and he always provides clear explanations and next steps

Rebecca T.

The office is clean, organized, and efficient. I was seen on time, and the entire visit—from check-in to labs—was smooth. Highly recommend for anyone looking for a great primary care doctor in Los Angeles.

James L.

I scheduled a telemedicine visit and it was so convenient. Dr. Lalezari was attentive and professional, and I received my follow-up instructions right away. Five-star experience.