Forms & Policies

Forms & Policies

Welcome to Desert Wells Family Medicine!

Thank you for completing your forms ahead of time. When you arrive for your appointment, please give your completed forms to the receptionist.

Adult Patient Packet

Pediatric Patient Packet

Annual Patient Information Form

Patient Sick/Well/Physical Form

Payment Policy & Phone Consent Form

HIPAA Patient Consent Form (English)

HIPAA Patient Consent Form (Spanish)

Notice of Privacy Practice (English)

Notice of Privacy Practice (Spanish)

What we offer

Services