New Patient Information

To expedite your check-in, please download and complete.

Please fill out all four pages to the best of your ability.

Additional Forms

If you have any questions when filling out these forms, please do the best you can and our staff will assist you with your questions on the day of your visit.

Payments

We accept the
following methods of payment.

Insurance Plans

We take the following insurance plans. If you have any questions regarding the plans we accept please do not hesitate in calling our office.

AARP Medicare Complete
Aetna
AHCCCS - Mercy Care
Arizona Foundation
Blue Cross & Blue Shield
Cigna
GEHA/Gilsbar
Golden Rule
Life Print
Medicare
Mutual of Omaha
Tricare
United Healthcare