Documents and Forms

Patient Information Sheet

Your basic information including your family, social, and medical history.
Pages: 2

Important: This form must be filled out and brought in for your first visit.

Download

Download the PDF above, print it out, fill it out, and bring it in for your first visit.

Staying Healthy Assessment

You and your health care team can work together towards better health. Adults, 18 years of age and older.
Pages: 2

Important: This form must be filled out and brought in for your first visit.

Download

Download the PDF above, print it out, fill it out, and bring it in for your first visit.

Authorization/Waiver Forms

Authorization Forms, Waiver Forms, Office Policies, TB Risk Assessment, Language Information, and Receipt of Privacy Practices.
Pages: 6

Important: These forms must be filled out and brought in for your first visit.

Download

Download the PDF above, print it out, fill it out, and bring it in for your first visit.

Testimonials

  • Looking for a great doctor... look no further! Dr. Samawi is caring and compassionate.

    Erica H., Studio City, CA
  • I had my first visit and he took his time with me, he was a great listener and I have confidence he knows what he's doing! Love this doctor!

    Diann B., Long Beach, CA
  • Dr. Samawi and staff are fantastic. They fit me in when I was sick, are fast with calling in refills, and there is almost no wait time in the office. Dr. Samawi is great.

    Suzanne D., Long Beach, CA

Services and Capabilities

  • Chronic Disease Mgmt. (Diabetes, Hypertension, etc.)
  • Preventative Health Exams
  • Sports Physicals
  • Family Planning
  • Well Woman Exams
  • Mens Health
  • Immunizations
  • Drug Screening for Businesses/Employers
  • Referrals to Other Physicians As Needed
  • Laboratory Services & EKGs
  • Diet and Exercise Managment