We would like to sincerely welcome you to Desert Jewel Obstetrics and Gynecology and look forward to meeting you at your first appointment. If you have any questions, please do not hesitate to call our office at any time.

Individual New Patient Forms (all forms must be filled out in Black ink)
Download Women's New Patient History Form (PDF Format. Size: 653 kb)
Download Men's New Patient History Form (PDF Format. Size: 646 kb)
Download Records Release Form (Microsoft Word Doc Format. Size: 30 kb)

• We will need you to arrive approximately 30 minutes prior to your scheduled appointment time to fill out the new patient paperwork. If you are bringing the forms with you, please arrive a few minutes early so that we may verify your insurance information.
• You will need to have your insurance card present at the time of your visit.
• If applicable, a copay will be collected at your visit. This copay amount is the Specialist or Office Visit copay listed on your card.
• Please bring all previous records that pertain to your visit with you to your appointment. You may also have your physician fax these records directly to our office fax at (480) 970-1938. Please call in advance to verify that we have received your records so that we may avoid a possible delay in your appointment time. If your previous physician requires written consent, you can download our Records Release form here (Microsoft Word Doc Format. Size: 30 kb).

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