Dr. Sampson
Thomas G. Sampson, M.D.
Hip Arthroscopy
Board Certified—Orthopaedic Surgery
(American Board of Orthopaedic Surgery)
Dr. Thomas G. Sampson trained in orthopaedic surgery at the University of California, San Francisco, where he currently serves as an Associate Clinical Professor. In private practice in San Francisco since 1982, Dr. Sampson is an internationally recognized expert in hip arthroscopy.
An innovative pioneer, he is credited with significant advances in arthroscopic surgery. He has published numerous peer-reviewed articles and written chapters for surgical texts, and lectures worldwide. Dr. Sampson is a prominent member of the American Academy of Orthopaedic Surgeons, the Arthroscopy Association of North America, the Western Orthopaedic Association, and the California Orthopaedic Association.
(See Dr. Sampson's Curriculum Vitae page here for more information.)
San Francisco Office
2299 Post Street, Suite 107
San Francisco, CA 94115
(415) 345-9400 (tel)
(415) 345-8049 (fax)
Corte Madera Office
2 Fifer Avenue, Suite 130
Corte Madera, CA 94925
(415) 345-9400 (tel)
(415) 345-8049 (fax)
STAFF AND COMMUNICATIONS
Connie Jardine, PA-C
Physician Assistant/Office Manager
(415) 345-9400x152
Michelle Contreras
Bookkeeper
(415) 345-9400x138
Mary Cronin
Surgery Scheduler/Personal Assistant
(415) 345-9400x145
Dulce Manalo
Front-Office Receptionist
(415) 345-9400x127
Please direct e-mail specifically for Dr. Sampson, or general communications, to:
INSURANCE INFORMATION
Dr. Sampson accepts all major insurance plans but is not a participating provider for some insurance plans. He is contracted with Three Rivers Provider Network (TRPN), a shared savings program. We recommend that you verify your benefits prior to scheduling a visit, and, as well, we will be glad to make inquiry with your insurance provider about coverage under your plan.
Dr. Sampson accepts Workers' Compensation only on a case-by-case basis or by tertiary referral.
Although Dr. Sampson is not a Medicare provider, you can still schedule an appointment with him. In order to do so, you will need to sign an Advance Beneficiary Notice (ABN) at the time of your visit, acknowledging that you understand that Medicare will not reimburse you for services rendered and that you will personally have to pay for them out of pocket.
PRINTABLE FORMS
For your convenience, you may complete the printable forms below and either fax them to our office ahead of time or bring them with you to your appointment. We recommend, in order to safeguard your personal information, that you do not e-mail these forms to us. If you have any questions regarding this process, please call our office.
Confidential Intake Form (Form 1 of 2)
Patient Pain Drawing (Form 2 of 2)