New Patient Login

Patient Forms

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If you're a new patient, please complete the New Patient Registration Forms below and bring them with your insurance card to your first appointment.

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All New Patient Registration Forms must be filled out BEFORE your appointment time or your appointment will be rescheduled.

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It is the patient’s responsibility to verify if their insurance plan is in network with our office.

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• New Patient Registration Forms

• Notice of Privacy Practices

• Insurance and Policies

 

If you would like our team to coordinate care with another physician practice, please complete the form below to authorize release of your medical record, or the authorization for another physician practice to disclose information to us:

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• Authorization for Medical Record Release Form

• Authorization to Release Protected Health Information Form

 

Advanced Directives (optional):

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• State of Arizona Living Will

• State of Arizona Durable Health Care Power of Attorney (POA) 

 

In order to view or print these forms you will need Adobe Acrobat Reader installed. 

 

Click here to download it.