Patient Forms

To speed the check in process and minimize your wait, we suggest that all new patients download the New Patient Packet and complete all the information requested prior to arriving at our office.

• Patient Registration Form. (Requires free Adobe Reader)

Additional forms available for download: (Require free Adobe Reader).

• Authorization to Disclose Health Care Information
  
• Authorization to Disclose Health Care Information (in Spanish)
• Medical Records Release to Deer Valley Medical
• Privacy Notice
• Privacy Notice (in Spanish)
• Communication Consent and Acknowledgement
• Communication Consent and Acknowledgement (in Spanish)
• Medicare Annual Wellness Form
• Financial Policy