Patient Forms & Insurance

To save you time, please fill out all new patient forms before you arrive. The forms include your medical history, your current medical issues, family history, insurance information, authorizations, etc.

New Patient Forms

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New Patient Forms Packet

All new patients are required to fill out a New Patient Info Form Packet. Please print, fill out, and bring ALL the completed forms in this packet, with you to your first appointment.
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Medical Release Forms

If you require us to send or receive medical records on your behalf, please sign and submit a Records Release Form.

If you want to allow your family member, caretaker, etc to have access to your medical and billing information, please sign and submit a Records Release Form.

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Patient History Forms

All new and existing patients are required to have a current Patient History Form on file. We ask that you update this form at least once per year. Please print, fill out, and bring this form to your next appointment.

Insurance

Most major forms of insurance are accepted. If you are uninsured we have affordable cash options.

  • Aetna
  • Arizona Complete Health
  • Arizona Priority Care
  • BlueCross BlueShield
  • Care 1st
  • Cigna
  • Health Choice
  • Health Net Federal Services
  • Humana/ChoiceCare
  • Medicaid
  • Medicare
  • TriWest Healthcare Alliance
  • United Healthcare

Based on HIPAA guidelines, this website is not considered a secure environment. Do not communicate information through this website that you, as the patient, want to remain confidential. Please call our office if you have any questions.

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