Good Communication Means Better Case Management and Less Stress
Our customer care team is available by phone Monday through Sunday, 7:00am to 5:00pm.
General Forms
- New Client Form – Download & Print / Fill Out Online
To be completed by you and then brought with you on your first visit. - Credit Card Authorization Form / Fill Out Online
To be completed by you & faxed to: 702-262-7000 - Prescription Refill Form
- Authorization for Treatment Form
- Client Info Sheet
- Recheck Patient Medical History Questionnaire
- New Patient Questionnaire
Cardiology Forms
- Authorization for Treatment Form
- Cardio CPR Level Form
- Client Info Sheet
- New Patient Medical History Questionnaire
Internal Medicine Forms
- Authorization for Treatment Form
- Client Info Sheet
- New Patient Questionnaire
- Recheck Patient Medical History Questionnaire
- New Consult Request Form
Neurology Forms
- Authorization for Treatment Form
- Client Info Sheet
- New Patient Questionnaire
- Recheck Patient Medical History Questionnaire
Ophthalmology Forms
- Authorization for Treatment Form
- Client Info Sheet
- New Patient Questionnaire
- Recheck Patient Medical History Questionnaire