HUMPHREY LU, M.D. FAAP

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*$10 form fee will be charged for all sports/camp/school/medication forms, with 3-5 business day turnaround; additional $10 fee is charged for Rush Service with 1-2 business day turnaround.

For New Patients and Transferring Patients, please fill out forms 1-5.  For patients transferring out of practice, please fill out form 6.


1.  Registration Form (PDF)

2.  Initial History Questionnaire (PDF)

3.  Patient Authorization to Release Records (PDF)

4.  Notice of Privacy Practices (PDF)

5.  Acknowledgement of Receipt of Notice of Privacy Practices (PDF)

6.  Request for Transfer of Records (PDF)

7.  After Hours Care & Office Policies (PDF)

There is a $100 charge for No Show appointments; please notify us at least 24 hours for checkups and 1 hour for sick visits in advance if you are unable to keep your appontment. Thank you.



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