If you are interested in becoming a new patient and would like to request an appointment, please email email@example.com or call 480-905-8755 x 203.
Once your appointment is scheduled, please print and complete our New Patient Registration forms. For Telehealth appointments, your paperwork must be received no later than one week prior to your scheduled appointment.
Completed forms and a copy of your insurance card (front & back) can be emailed to firstname.lastname@example.org or sent to our secure fax: 480-905-8851.
Packet Includes These Forms:
- Financial Agreement
- Patient-Client Information
- Patient Health Questionnaire
- Patient Services Agreement
- Anxiety Disorder Scale
- Credit Card Authorization
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