480-598-4145
Internal Medicine Doctors: Specialty in Adults and Primary Care

Forms

NEW PATIENTS

Do you have access to a Printer?

If YES, then please fill out these forms, print them and bring them with you to reduce your wait time.

If NO, you will be able to fill them when you come in for your appointment.

1. New Patient Registration,

2. Release of Medical Records from Previous Doctor,

REFERRAL FORMS

If you are a specialist office requesting for medical records for a patient who needs to be seen in your office please print out the form below and fax it to us in 480-598-4346.

This will ensure your office receives the records promptly.

1. Specialist Medical Records Request Form

 

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