Abrazo Brain and Spine

New Patient Info & Forms

For your convenience, you may complete new patient forms in advance. Please select and print from the options below, fill them out completely and bring them with you to your appointment.

If you are not able to complete the forms before your visit, please allow at least 30 minutes for completion in the office before you see the doctor.

Current Medications

Please bring all medications you are currently taking to your appointment.

Personal Identification Needed

Be sure to have your valid driver license and insurance card(s) with you.

Payment Policy

Due to recent changes in healthcare plans, some patients have questions regarding patient and insurance responsibility for services rendered. Our rates are representative of the usual and customary charges for our area. Please review our payment policy information below. You will be provided with a copy of this information to read and sign at your office visit. Please let us know if you have any questions or concerns.

Insurance

We participate in most insurance plans, including Medicare. If you are not insured by a participating plan, payment in full is expected at each visit. If you are insured by a participating plan, we must still verify your plan offers weight loss benefits. Knowing your insurance benefits is your responsibility. Please contact your insurance company to find out if you are covered for weight loss procedures. They should be able to answer any questions you may have regarding your weight loss benefits. You can also look for information on the insurance company’s website or ask your human resources department for details. Many employers cover weight loss surgery in their insurance plans.

Co-payments and deductibles

All co-payments and deductibles must be paid at the time of service. This arrangement is part of your contract with your insurance company. Failure on our part to collect co-payments and deductibles from patients can be considered fraud. Please help us in upholding the law by paying your co-payment and/or deductible at each visit.

Payments can be made in the form of cash, personal check or credit card. We accept MasterCard, Visa, Discover and American Express.

Coverage changes

If your insurance changes, please notify us before or on your next visit so we can make the appropriate changes to help you receive your maximum benefits. If your insurance company does not pay within 30 days, you will be responsible for the balance.

Classes & Events

The Abrazo Medical Group is committed to improving the health of our community by educating individuals about the importance of healthy behaviors and empowering them to make changes in their lives.

If you are significantly overweight, you may be at risk for a wide variety of health issues, including diabetes, heart disease, sleep apnea, breathing problems and depression. You are not alone. Take the first step in your weight loss journey by signing up for an information seminar today! Daniel Fang, MD facilitate surgical weight loss information seminars at Abrazo Scottsdale Campus and Abrazo Arrowhead Campus each month.

Enroll for a Class 
Pay My Bill

As part of our commitment to provide you exceptional service and the highest quality care, we have implemented a new Ele...
Insurance & Billing

Need to know if your insurance plan covers our physicians? Below is a list of our currently accepted insurance plans.
Patient Portal

Visit our patient portal to pay your bill or access your health records.