Forms
These forms, in digital format, can also be completed in our Patient Portal.
New Patient Paperwork- English
New Patient Paperwork – Spanish
Established Patient Yearly Update – English
Established Patient Yearly Update – Spanish
Release of Health Information
Patient Portal
Our Secure Patient Portal is another convenient a way for established families can contact our office for patient communication and billing. Here is a quick visual guide to where you’ll find your important resources.
Portal Resources Guide
- Request Test Results
- Request a Referral
- Ask a Medical Question
- Questions About Your Bill
- Accepted Insurances
- Financial Agreements
and Privacy Consent Forms - Immunization Schedule
- Pay Your Bill
- Make an Appointment
- New Patient
- Renew Prescription
Our Locations
West Valley
4137 N. 108th Avenue
Phoenix AZ 85037
Office: (623) 877-7337
Fax: (623) 772- 0686
Monday - Friday 8:00 AM - 5:00 PM
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Ballpark
3802 N. 53rd Avenue, Suite 160
Phoenix AZ 85031
Office: (623) 877-7337
Fax: (623) 247-6537
Monday - Friday 8:30 AM - 5:00 PM (closed for lunch)
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Goodyear
700 N. Estrella Parkway, Suite 110
Goodyear AZ 85338
Office: (623) 877-7337
Fax: (623) 932-2443
Monday - Friday 8:30 AM - 5:00 PM
(closed for lunch 12:30-1:30)
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Arcadia
4840 E. Indian School, Suite 100
Phoenix AZ 85018
Office: (623) 877-7337
Fax: (602) 956-0773
Monday - Friday 8:30 AM - 5:00 PM
(closed for lunch 12:30-1:30)
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Buckeye
4161 N Pioneer Dr, Suite 101
Litchfield Park 85340
Office: (623) 877-7337
Fax: (623) 267-4727
Monday - Friday 8:30 AM - 5:00 PM
(closed for lunch 12:30-1:30)
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Surprise
15264 W. Brookside Lane, Suite 155
Surprise AZ 85374
Office: (623) 877-7337
Fax: (623) 214-3219
Monday - Friday 8:30 AM - 5:00 PM
(closed for lunch 12:30-1:30)
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