Lorem ipsum dolor sit amet, consectetuer. Proin gravida nibh vel velit auctor aliquet. Aenean sollicitudin, lorem quis bibendum.

+ 0800 2466 7921

[email protected]
34th Avenue New York, W2 3XE

Recent Posts

Monday - Friday 08:00 - 20:00

Saturday and Sunday - CLOSED

+ 0800 2466 7921
34th Avenue

New York, W2 3XE

Follow Us

Book A Visit

Patient Information

Patient Information

Arizona Center Chest Diseases Patient Information

Prior to your first office visit at Arizona Center Chest Diseases, we will request you fill out several forms. Some of these forms provide demographic, insurance information, and HIPPA compliance information. Other forms provide the physician with an overview of your symptoms and health history from which to initiate your office evaluation.

Alternatively, the forms will be provided upon arrival for your visit. We ask that you arrive at least 30 minutes prior to scheduled office visit to provide enough time to complete the forms and questionnaires if not completed ahead of scheduled visit. If forms are complete, please arrive 15 minutes prior to scheduled appointment time.

Patient Portal

All patients are required to register with an account through our patient portal.  This facilitates better communication and less reliance on voicemail and other forms of messaging.  Our patient portal is used for all non emergent communication.

Patient Forms

Patient forms and questionnaire will need to be completed before your visit.  Please take time to download your forms from the portal before your visit.

Click here to go to the Patient Forms Downloads page.

Forms can be submitted online through our patient portal. Please call 602.264.5685 to get enrolled and registered for our patient portal.  You will receive an “invite” in the inbox of the email address you provide.  The instructions will require you to create a password for future future access.

PCP and referring doctor name

If you are being referred to our office by another specialist or a primary care physician, the names and contact information of your referring provider and primary care provider will be needed to facilitate subsequent communication and continuity of care.

Financial Policy

Please bring your insurance card and photo ID to each office visit. If your insurance changes, please notify our billing office immediately to confirm that our physicians are contracted with your insurance plan.

If your insurance requires a copayment for services, it will be collected prior to office visit. For your convenience, we accept cash, checks, and credit cards (MasterCard, VISA, and Discover). We do not bill secondary insurance for copay. If you do not make your copayment at the time of service, we reserve the right to assess a $25 surcharge to cover administrative costs to collect balance.

Scheduling and confirmation of appointments

We will call you to confirm your appointment 2 business days prior to your scheduled visit. If we are unable to contact you, we will leave a voice mail message. Please respond to voice mail and confirm your appointment by noon prior to the day of office visit to secure your appointment. If we do not have confirmation of appointment by noon on the day prior to scheduled appointment, then we may offer your appointment to the next person on the waiting list.

We require that you provide a cell phone or daytime phone number by which we can contact you for confirmation as well as any unexpected schedule changes.

We attempt to schedule all future follow up appointments at the time of check out from present office visit.

Schedule changes

Our office schedule and office physician availability is subject to change depending on our hospital coverage requirements. From time to time, it may be necessary to reschedule your visit. We recognize that this is an inconvenience and only requested as a last option. We appreciate your flexibility to accommodate any change.

If you are arriving late for your scheduled appointment

If you are arriving late for your visit for any reason, we appreciate notification when possible. We know that the unexpected happens and the delay may be outside of your control. We will make every effort to accommodate you as long as it does not cause further delay in other patient’s scheduled visit.

Cancellation policy

If you need to cancel or reschedule your appointment, a 48-hour notice is required. If you fail to keep your appointment without notification or last minute cancelation, a fee of $50 will be assed directly to you. We understand that schedule changes may be needed but we require sufficient notice so that we can provide service to other patients on the waiting list.

If you are calling for your doctor because you are sick or for other reasons

In the event that you need to speak with your doctor for an urgent or emergent concern, please call the office and leave a message detailing which doctor you are calling for and brief description of details. If your message is of a nonurgent matter, your concerns will be answered by portal message or phone call within 24 hours.

After hours calls

If you need to speak with a doctor regarding an urgent matter after regular office hours, please call the main office number which will be routed to the our answering service. Please provide the necessary information, unblock your phone number, and the on call physician will be notified. The on call physician cannot always respond immediately but will provide as much assistance as possible over the phone.

Prescription Refills

If you are running out of medication and need a refill, please notify your pharmacy. If you have not been seen in the office within the time requested on your last office visit, you may be requested to return for follow up office visit prior to refill. Please allow at least 72 hour response time.

Test Results

Test results will be communicated on the portal.  Additional details may be provided on individual bases depending on the circumstances.

Copy of medical records

Medical records will copied and provided upon request allowing 3-5 business days for response with $10 fee plus 10 cents per page for hard copy.

Disability forms

Any forms requiring completion by the office physician with be assessed a $25 charge.

Medication lists

We request that you bring all current or active medications or bring an up to date list of your medication with every visit. An up to date and current list of medications is very important in the collaboration and coordination of your care.

Chest X-rays, CT chest (CAT scans), and other imaging studies

If you have received any Chest X-Ray or CT Chest ordered by another provider, we request that you hand carry the images on disc from the imaging center for review during your appointment.

Prior authorization for tests

Depending on your insurance plan, prior authorization for outpatient test may be required. This can be a time consuming process that delays care or possibly changes the plan of care. This is not something that we have direct control over. We will do our best to communicate any delay or changes imposed by the insurance plan.

Prior authorization for nonformulary medications

Depending on your pharmacy coverage, prior authorization for a specific prescription may be required. In this case, please allow 7-10 days to complete paperwork. Completion of paperwork may be delayed by insurance carrier response times.