Patient Forms
We provide these documents online as a means to expedite your first visit and help you obtain medical records. The papers will be provided to you in person if you so choose.
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New Patient Forms
This form can either be filled out online or printed and filled in by hand at your convenience |
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Release of Medical Records Form
(For Medical Record Requests this can be filled out and either e-mailed or faxed to the office) |
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HIPAA Compliance Forms
These documents inform patients of their rights to privacy and the measures that are taken to preserve patient confidentiality. These forms can also be provided to you in person. These are provided for you to review prior to signing your HIPAA consent form. |
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Nueva Forma de Paciente en Espanol
| new_patient_forms__spanish_.pdf |
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Accident and Personal Injury Form
(For People with Car Insurance Claims. Fill Out Along With New Patient Form) |
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ADDRESS: 3984 N. Campbell Avenue, Tucson, AZ 85719
PHONE: (520) 321-1171
FAX: (520) 321-1183
For questions pertaining to Dr. Richard Skrill, contact rskrilldc@gmail.com
For questions pertaining to Dr. Gabriel Skrill, contact rskrilldc@gmail.com
HOURS OF SCHEDULED APPOINTMENTS:
PHONE: (520) 321-1171
FAX: (520) 321-1183
For questions pertaining to Dr. Richard Skrill, contact rskrilldc@gmail.com
For questions pertaining to Dr. Gabriel Skrill, contact rskrilldc@gmail.com
HOURS OF SCHEDULED APPOINTMENTS:
| Day | Hours |
|---|---|
| Monday | 10:00am - 3:45pm |
| Tuesday | 7:00am - 10:15am 12:00pm - 4:00pm |
| Wednesday | 10:15am - 3:45pm |
| Thursday | 7:00am - 10:15am 12:00pm - 4:00pm |
| Friday | 7:00am - 10:15am |