top of page

Intake Documents

Please select the applicable document button below and complete the form fully. Each e-form is HIPAA compliant and end-to-end encrypted to ensure full security of your PHI (personal health information).

Once completed, all you need to do is select "Submit" and the finished document will automatically upload to our portal. Please call/text (480) 501-9475 or email if you have any issues.
bottom of page