Patient Forms

Our friendly staff is committed to making your first visit with us as comfortable and efficient as possible. For your convenience our online registration is easy to use from a computer, tablet or mobile phone. Please enter the requested information to help us assist you and save you valuable time on the day of your appointment. Information you enter is secure and will not be shared with anyone outside of our organization. Below for easy reference is a helpful list we created to give you an idea of what information you will need to have on hand when filling out the online registration form. The entire process should take you about 5 to 10 minutes but for patients that have more medical history to enter, it could take a little bit longer.

If you prefer to fill out a paper version of our registration, then you can download them by clicking on the links below. Please print and fill them out and send them to us prior to your appointment by faxing them to (480) 515-3766. This will help get you in to see the doctor sooner.

Please also bring copies of any prior test results, your driver's license or picture ID, your insurance card, and any co-pay or deductible that applies.

If you have any questions, please feel free to contact us at (480) 515-0900.

Click the link for our Secure Online Registration: Online Registration

Information needed for online registration:

  • Medical Insurance Information
  • Pharmacy Information (Phone & Locations)
  • Current Physicians (Names & Specialties)
  • Medical Allergies
  • Current Medications (Dose & Frequency)
  • Prior Surgeries
  • Current Medical Problems
  • Family Medical History

*Please note that if you start the registration, you do not want close your browser down until you have submitted the form. The information you enter is temporarily saved in the browser but once you close it out, the information will be gone.

Click the links below to download paperwork