New Patients

Patient Forms

The following forms can be downloaded to your computer and printed at home. By filling out these forms ahead of time you will save significant time at the time of your visit. If you have any questions when filling out these forms, please do the best you can, our staff will assist you with your questions on the day of your visit.

Please printout and complete the appropriate forms:

• Patient Registration Form (Family Practice & Pain Management)
• Medical Questionnaire (Family Practice & Pain Management)
• Pain Intake Form (Pain Management patients only)

note: The above documents are in Adobe® PDF format. They require Adobe Reader to be viewed. If you do not have Adobe Reader, you can download it for free by clicking here. Fast appointment scheduling is available. We accept almost all private insurance plans, Medicare, and Worker’s Compensation.

Some of the Insurances We Accept:

Aetna	Great West
Ameriben	Humana
Arizona State Workers Compensation	Medicare
Arizona Foundation	Medicare Replacements
Beech Street	Multiplan
Blue Cross/Blue Shield	Pacificare
Champ Va	PCHS
Cigna	RAN
First Health	United Healthcare

If your insurance is not listed above, please contact our office for further information at 623-580-4357(HELP). We would be happy to assist you!

Frequently Asked Questions:

How do I make an appointment?
Appointments are made by calling our office at 623-580-4357 (HELP). Our fax number is 623-580-5249. You or your referring physician can call to set up the appointment. You do not need a referral to see us.

What are your office hours?
We are open Monday through Friday 8AM - 5PM
We also take walk ins between those hours.

What do I need to bring to my appointment?
For your first appointment you will need to bring your insurance card, any medical records, MRI or CT scan films will be helpful. If you do not have them, we can help you get them. A list of questions you wish to ask the physician. If your insurance requires you to have a referral, you are responsible for contacting your primary care physician to obtain that referral prior to your visit. Our office staff can help you do this if need be.

How long will the appointment last?
You should plan 30 minutes to an hour. 20-30 minutes for a follow-up visit. If you have an appointment there will be paperwork to be completed at your initial evaluation, so please plan to arrive 15 minutes prior to your appointment time.

What can I expect from my first visit?
We will go over your past medical history if applicable. We will determine where your pain is located and the severity of it. You will be given a physical exam and a detailed interview. Make sure to inform us of any treatment and medications you are taking. After a physical and diagnostic evaluation, we will design a treatment program specifically for you.

What type of insurance plans do you participate with?
We accept Medicare, Medicare replacement plans and most commercial insurances such as Blue Cross/Blue Shield, United Healthcare, Ameriben,  Aetna, Cigna, Humana, AZ Foundation, RAN, Multiplan, First Health, ChampVa, Beech Street, Pacificare, PCHS, SCF and Arizona State Workers Compensation.

Will you bill my insurance for me?
Yes we will bill your insurance carrier. It is important that you understand that this is not a guarantee of payment for your services. It is very important that we have your correct information in order to bill the insurance carrier. It is your responsibility to know and understand your insurance coverage as it pertains to deductibles, co-pays, pre-existing condition limitations. Please be aware that some services provided may not be covered services under your insurance plans. Please call our office to inquire about self pay options

Do I need to pay my co-pay and deductible at the time?
Yes, co-payment and deductibles are due and payable at the time of service. We accept cash, check, Visa, MasterCard and Care Credit.

Location

Our address is 2525 W. Carefree Hwy Building 5 suite 134. We are located on the south side of W. Carefree Hwy in the North Village Canyon Shopping Center. We are the last building in that shopping center to the very east of it. Our center faces the Carefree Hwy. We are located in the same shopping center as: Mountain Side Gym, Jack in the Box, and Connelly’s Sports Grill. We are located at the very end of the shopping center and are adjacent to a residential area and next to the Dentist office of Doctor Chris Munkel.

Address & Phone Numbers:

2525 W. Carefree Hwy, Suite 134
Phoenix, AZ 85085-6093
Phone: 623-580-4357 (HELP)
Fax: 623-580-5249

Appointments and Office Hours:

For your convenience, we offer regular scheduled appointments. We also welcome same-day appointments as our schedule allows. Our office is open 8 a.m. to 5 p.m. Monday through Friday. We are closed for all major U.S. Holidays.