Online Forms

Hippa Release Forms

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is composed of two main rules. The HIPAA privacy rule provides for the privacy of an individual's personally identifiable health information. The HIPAA Security Rule establishes standards for the privacy of electronic health information. HIPAA protects consumers from having their health information unnecessarily disclosed. The Department of Health & Human Services' Office for Civil Rights enforces HIPAA rules.

Patient Information Forms

Print these forms and fill them out before you arrive to save time!


Hours of Operation

Mon-Thurs: 7:30 AM - 4:00 PM
Friday: 7:30 AM - 12:00 PM

107 N Greenfield Rd
Suite 2
Mesa, AZ 85205