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Patient Information

Your First Appointment | Patient Forms | Insurance & Payment Information

Dr. Jain with a patient

What to Bring to Your Appointment

  • A list of current prescription or over-the-counter medications you are taking, including dose and frequency
  • Pertinent information about your medical and surgical history
  • Any recent x-rays or appropriate records you may have

Download Patient Forms

At the start of your first office visit, you will be asked to complete registration and health history forms. Please arrive 15 minutes early to allow time to complete these forms. Or you may print and complete these forms at home prior to your visit. Click on the links below to:

Troubleshooting:

The Acrobat Reader® plug-in is required in order to access the online patient forms. If you do not have the Acrobat Reader® plug-in, a free version is available from Adobe through their website.
To download the Acrobat Reader® plug-in, click here.

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Insurance Providers

Dr. Jain participates with and accepts the following insurance carriers and payment sources:

  • Aetna/U.S. Healthcare
    • PPO, POS, Senior
    • Aetna Open Choice - PPO
    • Aetna Partners - PPO
  • Affiliated Health Funds - PPO
  • Beech Street
  • Blue Cross/California Care
    • PPO, POS, Senior
  • Blue Shield
    • PPO, POS, Senior, Access
  • Care 1st
  • CCN (Community Care Network) - PPO
  • Tricare/Champus
  • Cigna Health Plans
    • PPO, POS
  • First Health Network - PPO
  • Health Net
    • PPO, POS, Senior
  • Medi-Medi
  • Medicare
  • Motion Picture & TV Fund - PPO
  • Great-West Healthcare (One Health Plan) - PPO
  • OneCall
  • PacifiCare of Cali. - PPO
  • Private Healthcare System (PHCS) - PPO
  • Self Pay or Cash Payment
  • United Healthcare of California - PPO
  • Universal Care
  • Workers' Comp

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Ravin Jain, MD

2625 West Alameda Avenue
Suite 326
Burbank, CA 91505
Tel: 818.566.9991
Fax: 818.566.9992
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Member of Neurology Channel