Patient Forms

Patient forms can be found below.

 

Click on one of the buttons below in order to open the corresponding PDF form.

Accepted Insurance

  • Aetna (with the exception of Bronze, Silver, or Gold)
  • Ameriben
  • Arizona Complete Healthcare: Ambetter & Wellcare
  • Blue Cross Blue Shield (with the exception of Medicare Advantage HMO, Alliance, and Pima Focus)
  • Cigna (with the exception of Health Springs or Medicare Advantage)
  • GEHA
  • Golden Rule
  • Humana
  • Medicare of Arizona
  • Meritain
  • Railroad Medicare
  • Tricare (with referral)
  • UMR
  • United Healthcare (with the exception of Navigate and Neighborhood plans)
  • VA (with referral)

AHCCCS Plans Accepted: United Healthcare Community Plan, Banner University Family Care

Don’t see your plan listed? Please inquire with our office to learn what coverage may be available.

COVID-19 Policy

Vita Medica Institute works to be prepared for all types of infectious diseases such as flu or coronavirus.  Vita Medica Institute’s staff work diligently to provide our patients with the highest standard of care.

 

 

For the safety of our patients and providers, we will not be evaluating patients who are acutely ill (patients experiencing fever, cough, shortness of breath, sore throat.) Likewise, patients who have recently tested positive for COVID-19, or have come into close contact with someone who has tested positive, will not be seen in-office until symptoms have cleared.  Please advise us of such situation by phone ahead of your appointment.  We have made telemedicine available to patients who cannot be seen in-office due to illness, so that you do not have to miss your scheduled appointment time.

Get in touch with our office