Our Train Station
7757 W. Deer Valley Rd.
Peoria, AZ 85382

Fax: 623-878-9150

Poison Control:

Request an Appointment

stop-sign.jpg For All Appointments Needed Within 24 Hours
Please Call Our Office
(623) 878-2800

Our office will respond to your request via email within 24 hours during a normal business week. If you would prefer a telephone call back, please indicate this in the note section below. Any requests made on a Friday after 4:00pm through Sunday will not be returned until the following week.

We encourage you to use the form below!

Personal Information of the Responsible Party

Personal Information of the Patient
Is Your Child a New or Existing Patient?:

Address Information

Insurance Information

About Your Appointment Request
Are You Willing to See Another Physician if the Physician You Just Selected is Currently Unavailable:

What Type of Appointment Does Your Child Need?:

Choosing an Appointment Time
Do You Prefer Morning or Afternoon Appointments?:


Final Information
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