Regent Medical Urgent Care

16872 N Cave Creek Rd, Phoenix, AZ 85032

(602) 494 7700

Please print and complete the following forms, and bring them with you when you visit us:

• Consent Form (PDF, 68k)
• Patient Data Sheet (PDF, 44k)
• Patient History (PDF, 32k)
• Patient Information Sheet (PDF, 68k)
• Privacy Practices (PDF, 72k)
• Release of Information (PDF, 48k)