Welcome to our practice

Here you will find forms for new patients to the practice a long with existing patients that are coming in for their annual wellness visits or annual exams.

If you need to cancel or change your appointment, please give us the courtesy of 24 hours notice at least. We allow a significant amount of time for each patient visit which go unused in the event of a last minute cancellation. Therefore, $50.00 is charged for failure to cancel within 24 hours.

Please contact our billing department with any insurance or billing questions. 623-349-1875

New Patient Package

Please bring an ID with you and your insurance card along with the package. It is our practice policy that you bring ALL medications BOTTLES except for controlled substance medications with you for each office visit. This ensures your safety and accuracy.

Annual Exam Patient Form

This form is for all 16-64 to fill out for their annual physical exams. (MANDATORY YEARLY)

AWV Patient Form

This form is for all 65 + and applies to Medicare and Medicare Replacement Policy Holders only. During the Medicare Annual Wellness Visit includes a review of medical history, surgical history, and family history as well as prescriptions and over-the-counter medications such as vitamins, minerals, and supplements. The practitioner also will review lifestyle habits, including diet, exercise, alcohol consumption, and tobacco use. This does NOT include a physical examination. If your practitioner discovers a serious problem during the Annual Wellness Visit, they will address it or provide a referral. All non-urgent problems will be addressed at a follow-up visit. (MANDATORY YEARLY)

• Weight
• Body mass index (BMI)
• Temperature
• Blood pressure
• Pulse
• Mood issues
• Memory problems
• Home safety
• Risk of falling                                                                                                                                                                                                                                                                                                                                         • Comprehensive Pain Screening