New Patient Information
Welcome to Kachina Family Medicine. We strive to create a positive experience every time you visit our practice. Prior to your first visit, please review the information below and complete the applicable forms. Thank you.
SCHEDULING:
To schedule an appointment call 480-706-4100 and choose option #1. If you have health insurance, you will need your insurance card to be able to make an appointment.
REGISTRATION:
To register as a new patient with our practice, each patient will need to complete 3 forms:
- Registration Form
- Financial Policy
- Medical History Form
Please print and complete these forms prior to your first visit. We do not have the capability for fax or e-mail handling of these registration forms, and ask that you bring them with you. Please arrive 15-20 minutes early to allow enough time for the registration process. You will need to bring your insurance card and completed registration forms. Also bring any current medication in their original containers. All minors must be accompanied by a parent on their first visit. Please bring the minor’s immunization record to the first visit.
INSURANCE BILLING:
We will file claims with any Insurance Plans with which we are contracted. All co-pays are due at the time of service. If you have a high deductible plan, 50% of the bill will be due at the time of service. If you have coinsurance, 5% of the bill is due at the time of service. If we do not participate in your health plan or you have no health insurance, fees for our services are due at the time of service. Please see our Financial Policy for further information about our billing guidelines.
