Scott M. Gulinson, MD, FACOG Call Now 602-678-1111

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Patients forms

Before Your First Visit

Dear Patient, please print these forms out prior to your first visit with us. You may fill them in and either mail/fax to us or carry themĀ  with you to your office visit. We appreciate your time and cooperation.

Patient Care Contract

HIPAA Privacy Practices Notice of Receipt

Ultrasound Consent/contract

Cosmetic Skin Care Survey

Medvoice Instructions

Insurance Coverage and Cancelation Policies

Patient Demographic/New Patient Information Summary

Notice of Privacy Practices Packet

Scott M. Gulinson, MD, FACOG