Needs
Coverage
Schedule
What can we help you with?
Select all needs that apply.
COVID-19
Coronavirus Testing (Virtual Only / Drive-thru)
With your COVID-19 testing appointment you will receive:
Available for individuals with symptoms or no symptoms
Virtual provider consultation prior to test
Antigen (rapid) test administered. Results in 10 minutes
PCR (standard) test administered. Results in 3-5 days (used for confirmation of Antigen test)
Back-to-work clearance paperwork if needed
Provider follow-up on positive results (ie. prescriptions and treatment plans)
Family Medicine & Primary Care
Cold, Cough or Flu
Sinus Infection
Pink Eye
Sore Throat
Ear Infection
Urinary Tract Infection
Sprain or Strain
Headache/Migraine
Nausea/Vomiting or Diarrhea
Hospital Follow-Up
Medication Refill
Annual Wellness Visit - Medicare
Skin/Rash/Moles
FMLA Paperwork
Something Else
Other
In-Office Only
Physical Exam - Adult (In-Office Only)
Physical Exam - Baby or Child (In-Office Only)
DOT Physical (In-Office Only)
Sports Physical (In-Office Only)
Vaccination (Not for Covid Vaccine - In-Office Only)
Virtual care from the comfort of your home
(Virtual Visits Within 24 hours)
Acne
Cold Sore
Stop Smoking
UTI
Mental Health
Women’s Sexual Health (hormones, birth control, hot flashes, etc.)
Men’s Sexual Health (premature ejaculation, erectile dysfunction, etc.)
Chiropractic Appointment
Low Back Pain (In-Office Only)
Neck Pain (In-Office Only)
Headaches
Car Accident (referred by Attorney call 888-407-7928) (In-Office Only)
Other (In-Office Only)
Pain Management Appointment
Neck Pain - Radiating Down Arm
Back Pain - Radiating Down Leg/Buttocks
Knee Pain – OsteoArthritis treatment
Other (In-Office Only)
Your need(s) are best served virtually.
Your need(s) are best served in-office.
Virtual Visit
In-Office
Next
How would you like to cover your visit?
Select the payment option that works best for you.
Insurance
Request an appointment
Health Insurance
Medicare
Medicare Advantage
Workers Compensation
Auto Injury
Redirect Health Member
Speak with a provider now (24/7)
or schedule a call
$0.00
No Charge / Free
Sign-Up for iEverydayCARE
Self-Pay
Request an appointment
Based on the selected needs, you may require multiple appointments.
$99 Telehealth
$99 Primary Care
$65 Chiropractic
$224 Pain Management – New Patient
$119 Pain Management – Established Patient
Fair Price Guide
HSA or High Deductible Health Plan
Request an appointment
Based on the selected needs, you may require multiple appointments.
$99 Telehealth
$99 Primary Care
$65 Chiropractic
$224 Pain Management – New Patient
$119 Pain Management – Established Patient
Fair Price Guide
What type of insurance do you have?
Medicare or Medicare Advantage
Health Insurance
Workers Compensation
Auto Insurance
Please select your medicare plan
Traditional Medicare
Aetna
Blue Cross
Cigna
Humana
United Healthcare
Other
Please select your insurance company?
We love HealthNet patients. As we are off-network, please see our
Fair Price Guide
Aetna
Blue Cross
Cigna
Health Net
Humana
Metlife
United Healthcare
Other
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Next
Have you had an appointment with us in the past 3 years?
Yes
No
Who is this appointment for?
Please fill out the patients information below.
First Name
*
Middle Name
Last Name
*
Email Address
*
Mobile Phone
*
Date of Birth
*
Gender
*
-- Gender --
Male
Female
Prefer not to say
Marital Status
*
-- Select --
Divorced
Married
Partner
Single
Unknown
Widowed
Legally Separated
Home Phone
*
Address
*
City
*
State
*
-- Select --
AK - Alaska
AL - Alabama
AR - Arkansas
AZ - Arizona
CA - California
CO - Colorado
CT - Connecticut
DC - District of Columbia
DE - Delaware
FL - Florida
GA - Georgia
HI - Hawaii
IA - Iowa
ID - Idaho
IL - Illinois
IN - Indiana
KS - Kansas
KY - Kentucky
LA - Louisiana
MA - Massachusetts
MD - Maryland
ME - Maine
MI - Michigan
MN - Minnesota
MO - Missouri
MS - Mississippi
MT - Montana
NC - North Carolina
ND - North Dakota
NE - Nebraska
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NV - Nevada
NY - New York
OH - Ohio
OK - Oklahoma
OR - Oregon
PA - Pennsylvania
PR - Puerto Rico
RI - Rhode Island
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VA - Virginia
VT - Vermont
WA - Washington
WI - Wisconsin
WV - West Virginia
WY - Wyoming
Zip
*
When and Where?
Preferred Date
*
-- Preferred Date --
Today
Monday - 06/12
Tuesday - 06/13
Wednesday - 06/14
Thursday - 06/15
Friday - 06/16
Saturday - 06/17
Monday - 06/19
Tuesday - 06/20
Wednesday - 06/21
Thursday - 06/22
Friday - 06/23
Preferred Time
*
-- Preferred Time --
Early Morning (7AM to 9AM)
Morning (9AM to Noon)
Early Afternoon (Noon to 2PM)
Afternoon (2PM to 4PM)
Evening (4PM to Close)
Preferred Location
*
-- Preferred Location --
Glendale
Scottsdale
Surprise
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Schedule Appointment
Appointment Request Received!
Expect a call from (623) 334-4000.
Thank you! Your appointment has been received. We'll get back to you right away, usually within 15 minutes during business hours.
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