Patient Forms

Locations

Avondale Office 13065 W McDowell Road, Suite C-130 Avondale, AZ 85392 Hours: Monday-Friday 8a.m. to 5p.m, Saturday 8 a.m. to 12 p.m
Laveen Office 7205 South 51st.Ave, Suite 102 Laveen, AZ 85339 Hours: MONDAY-FRIDAY 8 A.M. TO 5 P.M.
Phoenix Office 4700 N. 51st Avenue, Suite 4 Phoenix, AZ 85031 Hours: Monday-Friday 8 a.m. to 5 p.m.

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Accepted Insurance Plans:

·         All AHCCCS Plans

·         Aetna

·         Aetna Whole Health/Aetna Leap/Banner-Aetna

·         Ambetter (AZ Complete Care)

·         Ameriben

·         AZ Foundation (AZFMC)

·         Banner

·         BCBS

·         Beech Street

·         Cigna (ALL PLANS BUT LOCAL PLUS)

·         CorVell

·         Coventry/First Health

·         EverMed

·         Galaxy

·         GEHA

·         Gilsbar

·         Golden Rule

·         HealthNet

·         Humana

·         Meritain

·         PHCS/Multiplan

·         Provider Network of America

·         Tricare

·         Three Rivers

·         United HealthCare

·         UMR

·         USA Managed Health

·         Zelis Healthcare

 

Additional Details:

 

This list is not comprehensive as there are many insurance plans and sub-plans available.

We recommend that you check with your insurance company prior to your appointment to confirm your benefits, immunization coverage, and any specifics regarding pediatric care. Please remember that verification of benefits is not a guarantee of payment, and you are ultimately responsible for payment of all services that are not covered by your insurance plan once the claim has been processed. If you have any additional questions, please feel free to contact our office at 623-846-7575.

 

* For newborns, don’t forget to add your new baby to your policy within 30 days of birth; otherwise, services will not be covered by your plan.

Community Resources:

2-1-1 Arizona 211 http://arizona.myresourcedirectory.com Multiple resources
Care1st Avondale Resource Center 623-333-2703 http://www.avondaleaz.gov Multiple resources
Wildfire 602-604-0640 http://www.wildfireaz.org Multiple resources
Maricopa County Human Services 602-506-5911 https://www.maricopa.gov/5270/Human-Services Multiple resources
Chicanos Por La Causa 602-257-0700 http://www.cplc.org Multiple resources
Hope Women’s Center 602-715-0999 http://hopewomenscenter.org Diapers
Hope Women’s Center 623-875-4549 http://hopewomenscenter.org Diapers
Association of Arizona Food Banks 602-528-3434 http://www.azfoodbanks.org Food Resources
Avondale Food and Clothing Bank 623-932-9135 http://affcb.org Food Resources (Baby Box)
St. Mary’s Food Bank 602-242-3663 http://www.firstfoodbank.org Food Resources
New Life Center 623-932-4404 https://www.newlifectr.org/ Domestic Violence
De Colores Shelter 602-269-1515 http://www.cplc.org Domestic Violence
Community Action Program 623-222-1000 https://www.surpriseaz.gov/3549/Community-Action-Program-CAP Utilities Assistance
Community Action Program 623-936-2760 http://www.tollesonaz.org Utilities Assistance
AZ Dept. of Economic Security https://des.az.gov/services/basic-needs/community-action-agencies Utilities Assistance
AZ Dept. of Housing 602 506-2000 http://www.azhousing.gov Housing Assistance
Phoenix Rescue Mission 602-688-6211 https://phoenixrescuemission.org/ Homelessness