Central Phoenix Obstetrics & Gynecology

PATIENT PORTAL ACCESS/PAPERWORK

We respect your time. To expedite your experience on appointment day, please choose the category below that best describes your upcoming appointment to find a list of the forms you will need to complete prior to your appointment. These forms can be submitted securely directly to our office through the link provided.

If you are a new patient, click here.

Returning patients who need to access the portal, click here.

If you are a new patient, click here.

Returning patients who need to access the portal, click here.

NEW PATIENTS

Click on the link below that best describes your visit today. A menu will drop down with a list of forms to be completed on the patient portal before your appointment. The patient portal page will not have this specific list but you can click the BACK button to see the list again.

~~We look forward to seeing you.

New Patient--Annual exam

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Please bring all insurance cards (primary, secondary and tertiary), photo ID and a method of payment for your insurance assigned copay, deductible and co-insurance.

New Patient--Problem Visit

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Please bring all insurance cards (primary, secondary and tertiary), photo ID and a method of payment for your insurance assigned copay, deductible and co-insurance.

New Pregnancy (You have not yet been seen at this office for THIS pregnancy)

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Please bring all insurance cards (primary, secondary and tertiary), photo ID and a method of payment for your insurance assigned copay, deductible and co-insurance.

RETURNING PATIENTS

Click on the link below that best describes your visit today. A menu will drop down with a list of forms to be completed on the patient portal before your appointment. Please make sure to update your medical history if your last visit was a year or more ago. You will need to fill out the demographics update at every visit. The patient portal page will not have this specific list but you can click the BACK button to see the list again.

If you are a returning patient and just need to access the portal, click here. To reset your portal access, please call us at 602-288-0777.

~~We look forward to seeing you.

Returning Annual/Well woman Exam

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Insurance cards (primary, secondary and tertiary) and photo ID

Two days prior to your appointment please upload a picture of the front and back of your insurance card.

1.Login to your patient portal account

2.Click on the messages tab on the left side of the screen

3. Click on the button at the top of the page that says (+ SEND MSG)

4. In the drop down menu with the arrow select the “billing” option

5. The subject line should be “Insurance Card”

6. Click on the attach a file button and upload the pictures/documents

If you don’t upload this information in advance, please bring all insurance cards (primary, secondary and tertiary), photo ID and a method of payment for your insurance assigned copay, deductible and co-insurance.

Returning Problem Visit

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Insurance cards (primary, secondary and tertiary) and photo ID

Two days prior to your appointment please upload a picture of the front and back of your insurance card.

1.Login to your patient portal account

2.Click on the messages tab on the left side of the screen

3. Click on the button at the top of the page that says (+ SEND MSG)

4. In the drop down menu with the arrow select the “billing” option

5. The subject line should be “Insurance Card”

6. Click on the attach a file button and upload the pictures/documents

Returning Pregnant (You have already been seen at this office for this pregnancy)

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Insurance cards (primary, secondary and tertiary) and photo ID

Two days prior to your appointment please upload a picture of the front and back of your insurance card.

1.Login to your patient portal account

2.Click on the messages tab on the left side of the screen

3. Click on the button at the top of the page that says (+ SEND MSG)

4. In the drop down menu with the arrow select the “billing” option

5. The subject line should be “Insurance Card”

6. Click on the attach a file button and upload the pictures/documents

NEW PATIENTS

~~We look forward to seeing you.

New Patient--Annual exam

Please complete and submit ALL the forms below before your appointment.

Annual Medical History

Registration/Insurance Information

HIPAA Acknowledgement

Financial Policy

Annual Exam Consent

Review of Systems

If relevant, please also complete and submit

Insurance cards (primary, secondary and tertiary) and photo ID

Two days prior to your appointment please upload a picture of the front and back of your insurance card.

1.Login to your patient portal account

2.Click on the messages tab on the left side of the screen

3. Click on the button at the top of the page that says (+ SEND MSG)

4. In the drop down menu with the arrow select the “billing” option

5. The subject line should be “Insurance Card”

6. Click on the attach a file button and upload the pictures/documents

New Patient--Problem Visit

Please complete and submit ALL the forms below before your appointment.

Annual Medical History

Registration/Insurance Information

HIPAA Acknowledgement

Financial Policy

Review of Systems

If relevant, please also complete and submit

Insurance cards (primary, secondary and tertiary) and photo ID

Two days prior to your appointment please upload a picture of the front and back of your insurance card.

1.Login to your patient portal account

2.Click on the messages tab on the left side of the screen

3. Click on the button at the top of the page that says (+ SEND MSG)

4. In the drop down menu with the arrow select the “billing” option

5. The subject line should be “Insurance Card”

6. Click on the attach a file button and upload the pictures/documents

New Pregnancy (You have not yet been seen at this office for THIS pregnancy)

Please complete and submit ALL the forms below before your appointment.

Annual Medical History

Registration/Insurance Information

HIPAA Acknowledgement

Financial Policy

Review of Systems

If relevant, please also complete and submit

Insurance cards (primary, secondary and tertiary) and photo ID

Two days prior to your appointment please upload a picture of the front and back of your insurance card.

1.Login to your patient portal account

2.Click on the messages tab on the left side of the screen

3. Click on the button at the top of the page that says (+ SEND MSG)

4. In the drop down menu with the arrow select the “billing” option

5. The subject line should be “Insurance Card”

6. Click on the attach a file button and upload the pictures/documents

RETURNING PATIENTS

If you are a returning patient and just need to access the portal, click here. To reset your portal access, please call us at 602-288-0777.

~~We look forward to seeing you.

Returning Annual/Well woman Exam

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Please bring all insurance cards (primary, secondary and tertiary), photo ID and a method of payment for your insurance assigned copay, deductible and co-insurance.

Returning Problem Visit

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Please bring all insurance cards (primary, secondary and tertiary), photo ID and a method of payment for your insurance assigned copay, deductible and co-insurance.

Returning Pregnant (You have already been seen at this office for this pregnancy)

Please complete and submit ALL the forms below before your appointment.

If relevant, please also complete and submit

Please bring all insurance cards (primary, secondary and tertiary), photo ID, and a method of payment for your insurance assigned copay, deductible and co-insurance.