• Douglas M. Lakin
    Paradise Valley Medical Clinic
    Ph: (480) 614-5800
  • 9977 North 90th Street, Suite 180
    Scottsdale, AZ 85258
    Fax: (480) 614-6322
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Patient Forms

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Patient Info >

Patient Forms

Our New Patient Welcome Info Packet 2021
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 Notice of Privacy Practices
Our Patient HIPAA Notice of Privacy Practice 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
Check Your COVID-19 Risk – Based on best clinical practices, CDC guidelines, illness severity and risk factors like age and pre-existing conditions.
PVMC COVID-19 Office Appointment Pre-screening Questionnaire – Fillable – Complete & Print
Our Patient Pre-Physical Genetic Information & Screening Quiz
Our Patient Medicare Annual Pre-Physical Screening Forms – Fillable – Complete & Print

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

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