702 E. Bell Rd. #118, Phoenix, AZ 85022
(602) 404-3483
Early & Late Hours Available Patient Forms

New Patients

Patient Forms

Please print out the forms below and fill out to bring to your first appointment. Thank you, and we look forward to seeing you soon.

Patient Registration

Medical History

Financial Policy

Insurance

We accept most insurance plans, including Aetna, Ameritas, Assurant, Blue Cross of Arizona, Cigna Radius, Delta, Guardian, Connection GEHA, Humana, Metlife, Principal, United Healthcare and United Concordia. We also accept payment from PPO and indemnity plans. Please call our office to make an appointment, and we will answer any questions you may have.

Payment Options

We accept all major credit cards, ATM cards, cash, and personal checks. For our patients' convenience we have arranged a payment plan through a third party which helps patients receive their treatment in a timely manner.