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Phone: 480-505-3484 | Fax: 480-505-3348 Need Directions? / Have Questions?

Patient Forms

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Patient Forms

Click to download these forms in PDF (Adobe™ Reader) format:

  • New Patient Packet
  • Health History Form
  • Medical Records Release to Thompson Peak Family Care
  • Medical Records Request from Thompson Peak Family Care
  • Consent to Treat a Minor
  • Patient Demographics
  • Financial Policy
  • Notice of Privacy Practices
  • Acknowledgment of Receipt of Notice of Privacy Practices
  • Advanced Directives Information

Services offered:

  • Acute care 
  • Annual checkups 
  • Immunizations 
  • Well-child exams 
  • School/sports physicals 
  • Minor surgical procedures 
  • Fingerstick testing 
  • Management of chronic diseases 
  • Evaluation of musculoskeletal injuries and conditions

Phone: 480-505-3484 | Fax: 480-505-3348 Need Directions? / Have Questions?

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