Records Release Forms & Patient Paperwork
We strongly encourage our patients to print and complete paperwork prior to scheduled appointments. Please download the forms appropriate with your patient status.
New Patients/Re-Establishing Patients
If you are new to Accredited Family Healthcare, or have not been seen in the past three years you will be considered a new patient re-establishing care. Please use the download button below to print and complete your new patient forms.
If you are an established patient these forms are completed annually at your first visit of each new year. Please use the download button below to print and complete your annually updated forms.
Records Release Forms For Specialists/Transfer of Care
A records release form is available for you to complete so that we can acquire your previous records and/or specialist records. The same form can also be used if you plan to transfer care and would like us to send your records to your new provider. Our medical records fax # is 480.899.1404.
Medicare Insured Patients Only:
Medicare requires an Annual Medicare Wellness visit. This appointment organizes your specialist information and though there is some screening involved, it is different from the Annual Well Male/Well Woman Physical Exams we perform here at AFH to manage your overall health, but we often schedule both appointments together for your convenience. The forms below will need to be completed for the Annual Medicare Wellness visit whether you are seen in person or via telemed appointment. Please download, print and complete these forms only if you are a Medicare insured patient with either a Welcome to Medicare scheduled appointment or an Annual Medicare Wellness scheduled appointment.