Call us directly: 602.688.6500

Bell Rd, Phoenix: View Location

Union Hills Drive, Glendale: View Location

Our Forms

All new patients are required to complete the "Patient Registration Packet" before their initial examination. We encourage patients to log onto their online patient portal to complete the paperwork. It is the last link on the right of the webpage. Patients may also print and complete the packet at home and bring it to their first appointment with us if that is more convenient. Patients may also visit our office to pick up the new patient paperwork.

To access the online patient portal, we must have your email on file prior to you setting up an account. Please give us a call if you would like to sign up for the portal. You are also able to view and pay your balances through the patient portal.

For patients under the age of 18, a parent/legal guardian must be present at every appointment. If the parent or guardian cannot make it to an appointment, please fill out the "Authorization to Treat a Minor" form and list the individuals who are authorized to bring the patient to their appointments. For new minor patients, please also have the patient registration forms filled out and signed by the parent.

When you click on one of the first three links on the right, your browser will open up Adobe Reader. Select "Print" from the Adobe menu bar to print out the forms. If you do not have Adobe Reader 3.5 or later on your computer, you may download the most current version at no charge at

For Your Appointment

For your appointment, we will need:

  • Any relevant notes, diagnostic test results and/or x-rays.
  • Your insurance card.
  • A government-issued photo ID.
  • Most insurance plans require a co-payment at the time of service, so be sure to bring a form of payment with you. Our office accepts cash, checks, Mastercard, VISA, Discover and American Express.
  • If your insurance requires a referral from your primary care provider (PCP) to see a specialist, please bring the referral to your appointment. You may also call us to see if we have received it directly from the PCP's office. Failure to obtain a referral, when required, may result in the appointment being rescheduled.
  • Inform our office and your insurance company of any address or telephone number changes. Outdated information may cause a delay in the processing of claims.
  • If you are not insured or need to meet a deductible, our staff will be happy to work with you to make payment arrangements.

What About Insurance?

Medical care has never been as advanced as it is today, nor has it ever been so complicated. The typical doctor’s office maintains relationships with dozens of insurance companies, managed care organizations, primary physician’s organizations and other payers. Each has its own set of requirements concerning payment, patient co-payment and pre-authorization requirements. Please refer to the "Contracted Insurance List" link (on the right) to see a list of some of the insurances we take.

We want to work with you to assure that the care you receive is consistent with your insurance provider’s requirements. Since you, as the patient, are financially responsible for the cost of the care we provide you, North Valley ENT believes it is in your best interest to be actively involved with your insurance provider through this process. We try our best to verify each patient’s eligibility and benefits prior to their appointments. However, it is ultimately the patient’s responsibility to contact their insurance carrier to verify whether the provider they are scheduled with is in network with their insurance. We also encourage you to learn about your benefits and their limitations. If applicable, be prepared to pay your insurance co-payment or deductible at the time of service. It is also wise to be informed of any benefit restrictions due to pre-existing conditions. Find out if you have a deductible and whether or not it has been met, so you will be prepared if necessary to pre-pay some of the cost of your surgery.