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The secret in the care of the patient is in caring for the patient.

  • Douglas M Lakin, MD
    Kaitlin A Kraemer, PA-C
    Paradise Valley Med. Clinic
    Ph: (480) 614-5800
  • 9977 North 90th Street,
    Suite 180
    Scottsdale, AZ 85258
    Fax: (480) 614-6322

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    • Douglas M. Lakin, MD
    • Kaitlin A. Kraemer, PA-C
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Patient Forms

patient Forms
Emergency
Hospitalists
Patient Portal

Click any item below to download the form in PDF format.

General Patient Forms

Welcome to
Paradise Valley Medical Clinic!
Our New Patient Form Packet
fillable – Complete & Print
Our Summary of Patient
Office & Financial Policy Information – Sign & Print
Our Patient Information Update Form – Fillable – Complete & Print
Our Patient Medical History Update Form – Fillable – Complete & Print
Our Patient Medication History Update Form – Fillable – Complete & Print
Our Patient Release of Medical Records Form – Fillable – Complete & Print
Our Patient Pain/Controlled Medication Checklist Contract Form – Fillable – Complete & Print
Our Patient Pain/Controlled Medication Expectations of Patient/Caregiver Form – Fillable – Complete & Print
Our Patient Recommended Adult Immunizations
Our Patient Genetic Screening/Testing – Questionnaire Quiz
Our Patient Notice of Privacy Practices

Pain/Controlled Medication Forms

Our Patient Pain/Controlled Medication Expectations of Patient/Caregiver Form – Fillable – Complete & Print
Our Patient Pain/Controlled Medication Checklist Contract Form – Fillable – Complete & Print

Covid-19 Forms

Our Patient Medicare Annual Pre-Physical Screening Forms – Fillable – Complete & Print
PVMC Patient COVID-19 Moderna Vaccine Information – EUA
PVMC Patient COVID-19 Vaccine Consent Form – Fillable – Complete & Print
PVMC COVID-19 Office Appointment Pre-screening Questionnaire – Fillable – Complete & Print
Check Your COVID-19 Risk – Based on best clinical practices, CDC guidelines, illness severity and risk factors like age and pre-existing conditions.
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The secret in the care of the patient is in caring for the patient.

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