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Patient Information Forms

  • Please download the patient information form and complete it prior to your visit. Please bring a photo ID, insurance card, and completed patient form. 

    Patient Information Form (English) (Spanish)

Record Request Forms

  • If you would like to transfer or obtain a copy of your medical records, fill out the records request form. Please allow up to 10 business days to process each request. 
    Send the request form to [email protected] or
    fax to 602-296-0154.

    Records Request Form (English) (Spanish)

Patient Forms

Forms are in PDF format and require Adobe Acrobat Reader to open and print. This is a free program and is easy to install.  If you do not have Acrobat Reader, please install now to view our patient forms.

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We use qualitative data from LogRocket, UserZoom, Hotjar and AB Tasty to learn about your user experience and improve our products and services. LogRocket allows us to view session replays.