To expedite your first visit, please print out and complete the New Patient form, and bring it with you to your appointment. Thank you!
Michael Heffernan, M.D., Joseph W. Diehl, M.D., and Cheryl Ketelsen, PA-C are all currently accepting New Patients. Please call the office directly to schedule your New Patient appointment (805) 541-2650 or (805) 541-4180.
You can download and print our New Patient Forms by clicking on the blue links below. Please make sure to bring your Insurance cards, Photo ID, and legible list of Medications to include dosage to all appointments. Thank you. New Patient Forms: Please print and fill out the three forms below and bring to your New Patient appointment.
All patients please review Office Payment and Cancellation Policy below. Thank you.
Authorization to treat a Minor 10-2-18.pdf
Credit Card Authorization 9-1-17.pdf
Authorization to Release Records to Outside Physician – Santa Rosa Office.pdf
Auth to Release Medical Records to Patient – Santa Rosa Office.pdf
Authorization to Release Records to Outside Physician – Bishop Office.pdf