Schedule a Housecall

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Register for a Housecall Appointment

WELCOME

We are pleased that you have selected ElderConsult Geriatric Medicine to provide geriatric care for yourself or your family member. We look forward to working with you and will strive to provide you with the best medical care possible. This welcome message is intended to acquaint you with the basic practices of our medical group. Should you have any questions, please feel free to contact us.

Initial Assessment

  • Provide a complete physical exam, including cognitive and mood evaluation
  • Discuss medical concerns
  • Review medications
  • Discuss goals of care

This meeting will address pressing issues and we strongly encourage that all key family members and caregivers be present. My colleagues and I look forward to providing you with the best of care. We appreciate your trust.

Sincerely,
Elizabeth Landsverk MD, ElderConsult Founder

To begin the appointment process we are required to have you acknowledge notification of several items. Please follow the 4 easy steps below.

 

Step 1

Contact Us

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  • This field is for validation purposes and should be left unchanged.

Step 2

fill out secure online enrollment form*

*Also available as download.

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IMPORTANT: The form does not ‘save’ and will ‘time out’ so please have all information at hand prior to submitting.

Step 3

fill out our 5 required forms

There are 5 forms (below) and 1 the office will send that we need signed before we can work with your family. We will be able to schedule an appointment 72 hours after all the documents are received by our office. For your convenience you can download each form here. Please fill out and sign each item as indicated. If you have any questions please call 650-357-8834 x1.

Coverage Levels

This form indicates various coverage plans offered.

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Professional Services Agreement

This form details the various services we provide.

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Notice of Privacy Practices

This notice describes our use of your medical information.

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Authorization to Release Medical Information

This notice describes our use of your medical information.

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Medicare Opt Out Private Contract

This notice confirms you understand our Medicare Opt Out status.

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Step 4

COMPLETE PROCESS

Send a copy of each of the 3 items listed below PLUS the 5 forms directly above via fax at 650-357-8811 or email. After documents are sent, call 650-357-8834 x1 to complete the registration process.

1. Front and back of insurance cards

2. Medical Durable Power of Attorney

3. Financial Durable Power of Attorney