New To ClearPath Family Healthcare?

Start here

Complete your registration forms here

The packet above includes all required forms

Steps in the Registration Process

1

2

3

1

We will need your name, date of birth, contact information, insurance info & copies of your ID's

2

HIPAA, privacy policies & medical consent for treatment

3

medical history and family history

Check-list of Forms needed for registration 

  1. New Patient Forms

  2. Informed Consent for Medical Treatment

  3. Financial Consent

  4. HIPAA Consent

  5. Notice of Privacy Practices

  6. Patient Health History 

  7. Request for Medical Records

  8. HIE Opt-out

If you feel this is a life threatening emergency, please dial 911

Need More Help?

Call us at (623) 207-5465

Clinic Location

7725 North 43rd Ave Suite 720 Phoenix, AZ 85051

Scan to get our location on your mobile devise 

ClearPath Family Healthcare 7725 North 43rd Ave Suite 720 Phoenix, AZ 85051

© 2021 by ClearPath Family Healthcare LTD