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INFORMATION

New Patients

Below is a link for our new patient registration forms. Please print and fill them out and send them to us prior to your appointment by either faxing or mailing them. Our fax number is (602) 993-2922 and our mailing address is, 18275 N. 59th Ave, Suite 176, Bldg M, Glendale AZ 85308. This will help get you in to see the doctor sooner.

If you have any questions, please feel free to contact us at (602) 993-2622. Information needed for registration Forms:

  • Medical Insurance Information
  • Pharmacy Information (Phone & Locations)
  • Current Physicians (Names & Specialties)
  • Medical Allergies
  • Current Medications (Dose & Frequency)
  • Prior Surgeries
  • Current Medical Problems
  • Family Medical History

Click the link to download our new patient paperwork. Please note that you do need to mail or fax your printed out paperwork to us prior to your visit.
> New Patient Paperwork

Abdominal Surgery

Successful outcome of surgery involves both preparing before your operation and taking care of yourself during the recovery. These documents will guide you around the time of your operation:

Colonoscopy Patients

Download Colonoscopy Documents:

Outpatient Surgery

Successful outcome of surgery involves both preparing before your operation and taking care of yourself during the recovery. These documents will guide you around the time of your operation:

HIPAA Notice of Privacy Practices

THE LINK BELOW IS A NOTICE THAT DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

> Notice Of Privacy Practices – HIPAA

Useful Resources

These web links provide information for both patients and physicians, and may be useful to you: