HOME PROVIDERS
& LOCATIONS
IMAGING
& TESTING
CENTERS
SERVICES BILLING EMPLOYMENT FORMS ONLINE
BILL PAY
ACP Patient Portal
 
Make Health and Wellness
a Priority, Choose a
Community Physician
Patient Registration
For your convenience, we have provided our patient registration form below. Please print this form, fill it out completely, sign, and date. When completed please return to your Arizona Community Physicians provider's office either in person, mail or fax.
Medical Records
For your convenience, we have provided our medical record request form below. Requests for copies of your medical record must be made in writing and must be hand-delivered in person, mailed or faxed to your physician's office. Before sending the form please make sure your selection is complete, signed and dated.
HOME PROVIDERS
& LOCATIONS
IMAGING
& TESTING
CENTERS
SERVICES BILLING EMPLOYMENT FORMS ONLINE
BILL PAY