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New Patient Registration

Follow the following steps to register as new patient.

  1. Click on the PDF icon and download the new patient registration form.

  2. Print out and complete the form.

  3. Fax the completed form to our fax number (602) 279-3803.

Providing Healthcare to Minors


Usually, patients younger than 18 years of age may not receive urgent care medical services without the company of a parent or guardian except in certain circumstances:

  1. In an emergency.

  2. The patient is an “emancipated” minor.

  3. The service is one that the state law allows a minor to provide consent for (e.g., pregnancy-related services).

  4. The parent or guardian of the minor provided written consent for another adult to accompany the child and provide consent for treatment.

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