Patient forms

Skip the waiting-room clipboard.

Complete your intake online before your visit. Fast, secure, and from the comfort of your home.

Recommended

Online intake takes ~5 minutes.

Our chat-based intake captures everything we need — registration, medical history, insurance, and consent — in a single, secure session.

What we collect

The following is collected during your online intake. Printed copies are available at any of our offices on request.

Personal information, emergency contacts, and consent to treatment for new patients.

Past surgeries, current medications, allergies, and family health history — collected once, kept on file.

Insurance details and authorization for benefits assignment. Bring your card to your appointment.

Acknowledgment of our Notice of Privacy Practices in compliance with HIPAA regulations.

Prefer paper? Call 480-771-0000 or request forms at your next visit.