Patient Forms

We are pleased to introduce secure online services through our Patient Portal. Please access our Patient Portal to complete your registration forms. To connect to this portal:

1. Click the “My Patient Page” link above

2. Locate the box on the portal page that says “Register”

To Register you will need the PIN provided to you by our team when you scheduled your appointment. Your PIN will expire in 30 days.

Once registered you will need to ‘Verify your Identity’. Click on “verify my identity” @ the top right of page in royal blue color to continue registering with Portal. To complete this you will need to enter your First and Last name as it matches our records and your PIN number.


3. Complete the registrations forms to create your portal account and enable access to our online services.

If you are unable to complete your forms thru the Patient Portal please arrive early for this visit as you will be asked to complete a Patient Information Form and also a Medical History Form. This becomes a permanent part of your medical record. You will need the names and dosages of your current medications.You will be asked for insurance information. If your insurance requires a referral, we will need this when you check in. If you do not have your referral, and was not faxed by your Primary Doctor, your appointment may be delayed or rescheduled. If there are medical records or X-rays from another doctor that will help us better serve you, please bring them with you.

PATIENT BACK FORMS - Only for Dr. Song’s patients. {CLICK ON FORMS BELOW FOR DR SONG SPINE/BACK PATIENTS ONLY} Please bring completed forms to your appointment.

Follow up visit back Form
Surgery Follow up Form

All New Patients for Dr Song need to complete these forms.

New Patient Back Form

 

You will need Adobe Acrobat to view these forms.

 
Canyon Springs Medical Plaza, 2940 E. Banner Gateway Dr., Suite 200, Gilbert, AZ 85234 - T: 480.964.2908      F: 480.833.2136
Rome Towers - 1760 E. Pecos Rd Suite 207 Gilbert, AZ 85295