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New Patient Information
Welcome to Kachina Family Practice. It is our intent that your experiences with us will be positive in every aspect. Below, we
have listed information that we hope will smooth your initial visit
with us.
SCHEDULING:
To schedule an appointment call 480-706-4100 and choose option #2.
If you have health insurance, you will need your insurance card to be able to make an appointment.
REGISTRATION:
To register as a new patient with our practice, each patient will need
to complete 3 forms: Registration Form,
Financial Policy and Medical
History Form. You may click on the appropriate form, download it and
print it for completion prior to your first visit. We do not have the
capability for fax or e-mail handling of these registration forms and ask that you bring them with you. Please arrive 15-20 minutes early to allow
enough time for the registration process. You will need to bring your
insurance card and completed registration forms. All minors must be accompanied by a parent on their
first visit. Please bring the minor's immunization record to the first
visit. Also bring any current medication in
their original containers.
INSURANCE BILLING:
We will file claims with any Insurance Plans with which
we are contracted. All co-pays are due at the
time
of service. If you have a high deductible plan, 50% of the bill will be due at the time of service. If you have coinsurance, 5% of the bill is due at the time of service. If we do not participate in your health
plan or you have no health insurance plan, fees for our
services are due at the time of service. Please see our Financial Policy
for further information
about our billing guidelines.
Web site and all contents Copyright Kachina Family Practice, P.A., 16611 S 40th Street, Suite 120, Phoenix, Arizona 85048 All rights reserved.
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