Your medical history is imperative to a successful visit
Please print and complete all forms prior to your appointment. If you prefer to fill out the forms in person, we ask that you arrive at least 30 minutes before your scheduled appointment time.
Our patient services representatives are here to help! Give us a call at 480.428.3232, or email us at email@example.com.
Intake Forms Please download the intake form that applies to you (or the patient being seen):
- Patient Intake Form Adult, 16 years and older (Medical Center & Neil Riordan Center for Regenerative Medicine)
- Patient Intake Form Child, 0-15 years
New Patient Forms: Download and complete all of the following consents and legal documents:
- Patient Rights and Responsibilities
- Confidential Patient Demographic Form
- Notice of Privacy Practices
- Acknowledgement of Receipt of Notice of Privacy Practices
- Patient Payment and Appointment Cancellation Policy
- Consent for Treatment
- Consent for Acupuncture Treatment Form
- Electronic Communication Consent
For a Copy of Your Medical Records
Get your medical records from Southwest College of Naturopathic Medicine through RecordQuest by clicking here.
We've made it faster and easier to request medical records from Southwest College of
Naturopathic Medicine. On Friday, March 19, 2021, we launched our Request Portal
powered by RecordQuest. We appreciate your cooperation in submitting all future
requests through this site.
With the new Request Portal you can:
- Upload request documents, authorizations, and subpoenas
- Get an acknowledgment of receipt
- Specify your own reference code