Are you a new patient and scheduled your appointment? Please fill our new patient packet entirely. The forms can be faxed to 480.361.8216 or emailed to firstname.lastname@example.org prior to your scheduled appointment. Please include your insurance information on the first page so we can check your out-of-pocket expense prior to your appointment. If you have any questions call 480.272.7140
New Patient Packet Form (PDF Fillable Form)
New Patient Packet Form (Word version)
Pediatric New Patient Packet Form (Word version)
No insurance or you prefer to take advantage of one of our discounted self-pay programs? Check out our Self pay rates.
Cash Pay Rates (PDF)