AHCCCS (Any and All Plans)
CMDP
Care 1st
Health Choice
HealthNet Access
Kids Care
Maricopa Health Plan
Mercy Care
Phoenix Health Plan
United Healthcare Community Plan
University Family Care
Workman's Compensation
CHAMPVA
TRICARE
First Health Network
Coventry

Releasing & Obtaining Medical Information

Aetna (Including Banner Aetna Plans)
Ambetter
Arizona Foundation for Medical Care
Arizona Medical Network/Rural Arizona
Network (AMN/RAN)
Beech Street Network
Blue Cross Blue Shield
Evolutions Network
FPN
Galaxy Network
GEHA
Great West

Accepted Insurances

Authorization to Obtain & Release Form

Health Net
Health Star Network
HMN
Humana (Choice Care Network Only)
IHP
Lifewise
Medicare
MultiPlan
OptumCare/Lifeprint (Established Patients Only)
Private Health Care Systems (PHCS)
Three Rivers Network
United Healthcare
United Payors
USA

Pediatric New Patient Forms

Insurance Information

Insurances Not Accepted

Are you a new patient to our practice?

Please fill out the paperwork below before your first visit or arrive 20 minutes prior to your appointment to fill out in office.

New patients over the age of 18 are required to fill out new patient paperwork before their first visit. Pediatric patients 17 and under will need to have paperwork filled out by a guardian.

CARING FOR FAMILIES

Call Us: +1- 480 -783 -7000

Please Note: All fields are required on new patient paperwork.

Adult New Patient Forms (18+)

These forms allow patients to authorize records to be sent or obtained by Caring For Families:

We accept most major insurance companies, below you will find lists of common insurance companies we accept and do not accept. However, due to the many different insurance plans available, please contact your insurance to verify if our office/providers are in network with your specific plan even if it is listed below. Also, for any HMO plans, one of our providers must be listed as the designated PCP prior to your appointment.

We do also offer discounted cash pay prices for any patients needing to pay Fee For Service, please call for pricing.

Please Note: Our office DOES NOT verify insurance benefits prior to your appointment.