No Referral Required

Pre-op clearance. Fast and thorough.

Board-certified family medicine physicians providing surgical and medical clearance in Costa Mesa and Orange, CA. History & physical with basic labs included — no referral needed.

from $175
H&P + basic labs included
+ $75 if extensive labs required
Request Clearance

What’s included

Full history & physical (H&P)
Basic labs included
EKG if required (additional $100)
Clearance letter for surgical team
Direct communication with your surgeon
Fast turnaround — often same day
Costa MesaOrange
Board-Certified Family Medicine
Basic Labs Included
Fast Turnaround
Both Locations Available

Simple, fast, thorough.

01

Submit your request

Fill out our online intake form below with your information, services needed, and any paperwork from your surgical team.

02

We review and schedule

Our team reviews your request and contacts you to confirm your appointment. We prioritize urgent clearances.

03

Come in for your visit

Your physician performs your history & physical, reviews your medical history, and orders any required labs or EKG.

04

Receive your clearance

Your clearance letter and documentation are prepared and sent directly to your surgical team. Fast turnaround guaranteed.

We provide clearance for all surgeries.

Our physicians are experienced with pre-operative requirements across all surgical specialties.

Orthopedic Surgery

Cardiac Surgery

General Surgery

Cosmetic & Plastic Surgery

Bariatric Surgery

Ophthalmology

Gynecological Surgery

Urological Surgery

Dental & Oral Surgery

Spine Surgery

ENT Surgery

Any other surgical procedure

No surprises. Ever.

Most Common
$175

History & Physical + Basic Labs

Full history & physical
Basic metabolic panel
CBC (complete blood count)
Clearance letter
Available at both locations
Comprehensive
$275

History & Physical + EKG

Everything in standard
EKG included
Extensive labs — additional $75 if required
Ideal for complex procedures

Lab requirements vary by surgeon and procedure type. Your physician will determine the appropriate labs at your visit.

Need an EKG with your clearance?

Many surgical teams require an EKG as part of pre-operative clearance. We can perform both in the same visit.

Learn about our EKG services →

Fill out the form below to get started.

Our team will review your request and contact you within one business day to schedule your appointment.

Patient Information

Services Needed

Not sure what you need? Upload the paperwork from your doctor below and we’ll figure it out for you.

Preferred Location
Surgery Information
Upload Documents

Upload referral paperwork or pre-op orders

PDF, JPG, or PNG · Max 10MB per file · Multiple files accepted

Choose Files
Additional Notes

By submitting this form you consent to being contacted by Amity Health DPC regarding your clearance appointment.

Common questions about clearance.

Ready to get cleared?

Both locations available. We prioritize urgent clearances and aim for same-day turnaround.

Request Clearance

Questions? Call or email us directly.

📞(949) 791-8888
📠Fax: (949) 298-9094
✉️hello@amityhealthdpc.com
🕐Mon–Fri · 9am–4pm

Surgical teams may fax referrals directly to (949) 298-9094