Office Forms

In order to make your visit with us as productive as possible, we request that the following be reviewed, completed, and signed prior to making an appointment. Please be advised that the arbitration must be completed and returned in color and may not be altered. If you do not have access to a color printer or scanner, our patient care coordinator can send this to you prior to your visit or you may sign it in our office the day of your consultation. We also ask for a clear copy of the front and back of your insurance cards and photo ID.  

  • Please complete all the below forms and send a copy of your insurance cards and photo ID to or by fax 415-395-9897.



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Office phone: 415-395-9895

Fax: 415-395-9897

After hours: 855-638-7424


45 Castro St, Suite 324

San Francisco, CA  94114


Mon - Fri: 830am - 4:30pm

Closed for lunch: 12pm - 1pm

Gender Realignment Surgery (GRS)

Gender Confirmation Surgery (GCS)

Transgender Surgery San Francisco 

SRS San Francisco

Peritoneal Pullthrough


(C) 2021 MoZaic Care, Inc