If you are a prospective patient looking to schedule an appointment, please call us and we can fill out your intake form over the phone. Or, if you prefer, you can fill out our intake form and fax it to (575) 524-3721 or mail it to 1155 Commerce Dr., Suite C, Las Cruces, NM 88011.

See our Appointments page for more info.

Once you have an appointment, you can download the following forms and bring them to your first appointment. Click on each of the following forms to download. Please do not mail, email or fax the forms in advance.

  1. New Patient Information (O para español)
  2. Notice of Privacy Practices (en español)
  3. Written Acknowledgment of HIPAA NPP  (en español)
  4. Patient Demographics   (en español)
  5. Medical History   (en español)
  6. IV Calendar Notes
  7. Notice to Patients  (en español)
  8. No show policy
  9. Patient Agreement   (en español)