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NEW PATIENT FORMS 

New Patient Registration Form 

Acknowledgement of Privacy Agreement 

Patient Medication List 

Accepted Insurance Plans
(Please verify with your insurance plan to determine in-network status and is a referral is required)  

  • ​AARP/AZ plans only                   

  • Aetna/Meritain

  • AIP

  • All Medicare Supplement Plans          

  • Allwell

  • AZ Foundation 

  • Banner Health 

  • BCBS

  • BCBS of Arizona  

  • Champ VA 

  • Cigna

  • Coventry Mail Handlers 

  • Devoted Health 

  • Equality Health​

  • First Health 

  • GEHA / GEHA ASA​

  • Gilsbar​

  • Gold Kidney​

  • Health Net 

  • Humana 

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  • GEHA / GEHA ASA

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  • Gilsbar

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  • Gold Kidney

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  • Health Net 
     

  • Humana 

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  • Liberty Health Share (LHS)

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  • Medica 
     

  • Medicare/ RR 
     

  • Multi Plan 

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  • MVP Health PPO

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  • Pacific Source (Out of Network)

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  • Philadelphia PPO

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  • TriCare (Health Net) 
     

  • TriWest/ WPS- VAPC3

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  • Ucare Multi Plan Network
     

  • UHC
     

  • UMR

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  • Workmans Comp

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  • WPS Health Plan 

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  • VA: WPS-VAPC3

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14666 N. Del Webb Blvd
Sun City, AZ 85351

(623) 933-3107

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