Phone: (480) 461-1088
Fax: (480) 461-1657
Mesa Office
Queen Creek Office

  • Home
  • Physicians
    • Philip G. Foutch, D.O.
    • Robert L. Sawyer, M.D.
    • Andrew Gradé, M.D.
    • Sumir Patel, M.D.
    • Shiv Verma, M.D.
    • Nilay H. Kavathia, M.D.
    • Laurie Peterson, PA-C
    • Rebecca L. McCollaum, FNP
  • Services
    • Open Access Colonoscopy
    • Consultation
    • Colonoscopy
    • EGD / Enteroscopy
    • Wireless pH Monitoring
    • Esophageal Manometery
    • Capsule Endoscopy
    • Liver Biopsy
    • Remicade© Infusion
  • Locations
    • Mesa Office
    • Queen Creek Office
  • Referring Providers
  • For New Patients
    • New Patient Information
    • Download Forms
    • Insurance Information

Forms

Authorization to Release/Obtain Medical Records

Financial Policy Form

Notice of Privacy Practices

Patient Interview Form

Patient Registration Form

Notice of Nondiscrimination

Consent to release medical information to family/friends

For New Patients
  • New Patient Information
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  • Download Forms
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  • Insurance Information
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