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Patient Forms

Click on one of the links below to either View, Save or Print the forms

 

Office Policies Patient Registration

Patient Payment PolicyAuthorization for Release of Medical Records

Financial PolicySpecial Fees

Patient ResponsibilitiesHIPPA - Privacy Practice

Review of SystemsPatient History Form

Print New Patient Fors

 

I M SPECIALIST, INC       2737 W. Baseline Rd, #24, Tempe AZ 85283

Phone: 602-437-4800      Fax: 602-437-4805