New Patient

Join VPMR

The New Patient Packet should be completed and brought with you to your first visit or you can email it to [email protected]. These forms can be printed and filled by hand or filled digitally in Adobe Reader using "fill and sign" or printed (Document must be downloaded before filling it out).

If you have any questions or need help understanding any details throughout these forms, please feel free to call our New Patient  Coordinator, Airam (602-848-5237) call or text available,  or our Billing Manager, Jennifer (602-848-5236) call or text available.