Downtown Clinic 661.631.8793
Rosedale Aquatic Clinic 661-529-2303
Delano Clinic 661.558.1100
Main Fax 661.631.9257

Request Appointments
Scheduling@jacobopt.com
Submit Referrals
referrals@jacobopt.com
Fax: 661.631.9257

PATIENT FORMS

For your convenience, we’ve provided our patients forms on our website. To help expedite your first visit, please download, print and complete the forms. Bring them with you when you come in for your first visit. If you choose to fill out the patient form packet at our office, please arrive 10-15 minutes before your appointment to allow enough time to get them completed before your appointment.

If you are a new patient and are scheduling your first appointment, please see the list of forms below to find the required forms you will need to bring with you on your first visit. You will need to bring a photo ID and a copy of your insurance card if you will not be paying cash.

* The direct access disclaimer is only needed if you do not have a referral from a doctor

** the lein form is only needed if you were referred to us by your attorney and your case is a lien case

Our Downtown Clinic

1820 Chester Ave
Bakersfield, CA 93301
 
Monday – Friday:
9 AM – 6 PM
Saturday & Sunday:
Closed
 

Northwest / Aquatic Center

3850 Riverlakes Dr
Bakersfield, CA 93312

Monday – Friday:
9 AM – 6 PM
Saturday & Sunday:
Closed

Phone: (661) 529-2303

Our Delano Clinic

929 Jefferson St
Delano, CA 93215
 
Monday – Friday:
9 AM – 6 PM
Saturday & Sunday:
Closed