Patient Forms


 

We have uploaded forms here for you to access prior to coming to the office.  You can download and print these forms and bring them in prior to your appointment for your convenience.  

If you are a new patient establishing care with Phoenix Health & Wellness PC, please read the Notice of Privacy Policies, Notification of Separate Medical Practices, and Consent to Treatment.  These forms will need to be signed by your initial office visit.  The Authorization of Release of Medical Information (PHI) form can be downloaded and printed. 

If you have scheduled an annual wellness exam, please read the Annual Wellness Letter and Checklist and fill out the Annual Wellness Visit Form and complete the Health History Questionnaire.

These forms can not be sent electronically because they contain sensitive and identifying information and will need to be brought in person at the time of your appointment.  If you have any questions, please contact Phoenix Health & Wellness PC at (916) 299-6501.  

  1. New Patient Letter
  2. Notice of Privacy Policies
  3. Consent to Treatment
  4. Authorization of Release of Medical Information
  5. Annual Wellness Letter and Checklist
  6. Annual Wellness Visit Form
  7. Health History Questionnaire
  8. Patient Policies and Procedures
Location
Phoenix Health & Wellness PC
6600 Mercy Court, Suite 150
Fair Oaks, CA 95628
Phone: 916-299-6501
Fax: 916-581-6405
Office Hours

Get in touch

916-299-6501