Patient Forms

Schedule an Appointment

Phone: 520-624-8535

Please fill out these 3 forms.

1. Health History Form

(Choose One)

Patient Health History Form English

O En Español

(Legacy Printable PDF Versions)

Printable Versions: PDF Printable New Patient Form English

Imprimible: Paciente Nuevo Formulario de Registro imprimible Español

2. Financial Declaration

(Choose One)

Financial Declaration Form Online English

O En Español

(Legacy Printable PDF Versions)

English Financial Declaration Form PDF Printable

Español Formulario imprimible de declaración financiera

3. HIPAA Practices

(Choose One)

HIPAA Privacy Practices Online Form

O en Español

(Legacy PDF Printable Versions:)

HIPPA Privacy Practices

HIPAA en español