Panacea Brain and Spine

Patient Forms


VERY IMPORTANT: In order to provide you with timely and efficient care, please print and complete all three forms before coming to the office for your appointment. Be sure to bring your medical records and any pertinent diagnostic studies(CD and/or Films) with you to your appointment. If you do not bring your CD and/or films with you we will have to reschedule your appointment.

Please click below to download ALL five forms.

New Patient Information

Notice of Privacy

HIPPA Compliant Authorization

STARK Law Patient Notice

Arizona Advance Directive for Health Care Planning