Doctors & Staff

Patient Forms

To update your file in our office or for your first visit please complete the patient intake form:

For a copy of our Office Financial Policy that you will be asked to sign on your first visit:

If you would like to have records sent to a third party from Papago Buttes Pediatric Center:

If you would like to have records sent to our office from a previous physician or office:

Medical history form is to be completed by all new patient and new additions to your family for their first visit to our office:

For a quick guide to follow when calling your insurance company for provider participation and benefits information:

The Adult Patient Form (18yr+) is to be completed by the patient if they would like to give Papago Buttes Pediatric Center permission to discuss items with their parents:

The Medical Authorization Form is to be completed by any Parent or Legal Guardian that want to give permission to schedule, bring their children in for visits, call for information, etc….:

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Papago Buttes Pediatric Center is dedicated to providing you and your children the highest quality of pediatric medical care. Serving Phoenix, Arizona since 1963. omedix