Patient Forms

Scheduling Your Visit

To schedule an appointment with our office please call 602-866-1974.

Please let us know if you have a preference with respect to provider or time of day. Be sure to check with your insurance plan to see if you are required to have a referral from your primary care provider prior to seeing one of our physicians.

Getting Ready for Your Visit

In order for us to provide the best care for you, it is very important that you bring the following items to your visit:

• Photo ID
• A list of your current medications
• Any and all x-rays films
• Insurance information and card
• Information about what treatments and medications have been tried in the past
• Medical records from prior visits that you think may be helpful
• New Patients: download a patient registration and medical history forms below

Download Patient Forms

To view the forms listed below, you will need Adobe Reader. You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.

• New Patient Registration Form
• 18+ Patient Registration Form
• Release of Records Form
• HIPAA Notice of Privacy Practices

Insurance Information

Northwest Clinic for Children participates in most insurance plans. Please call the office to verify if we accept your plan.