Patient Forms

DOWNLOAD NEW PATIENT PACKET
DOWNLOAD NOTICE OF PRIVACY PRACTICES
DOWNLOAD HEALTH HISTORY UPDATE FORM
DOWNLOAD FINANCIAL FORM
DOWNLOAD YEARLY PATIENT PACKET

Welcome to Arizona Arrhythmia Consultants, we would like to take this opportunity to welcome you to our practice and thank you for choosing Arizona Arrhythmia Consultants for your healthcare needs. We invite you to begin your new patient registration by following these simple instructions.

  1. Print and complete New Patient Packet & Financial Form

  2. Prepare for your office visit. In addition to completing the above forms, we will also need you to bring the following information for your first visit:

    • Insurance card(s) and any co-payment due for visit

    • Bring a current list of your medications (including any over the counter or herbal supplements you may be taking)

    • Your referral form (if applicable)

    • Dirver's license or any other form of valid government issued photo ID (this is required to prevent insurance fraud)

  3. We ask that you arrive 15 minutes prior to your appointment time if you are a new patient or have not had a visit in 3 or more years with us. We thank you for taking the time to prepare for your appointment and we look forward to seeing you.