Welcome to Longevity Medical Health Center!

In order to provide you with the best of care, you can expect your initial consultation to last 1 to 1.5 hours in order to fully assess your health and wellness concerns. Please plan on arriving 30 minutes before your appointment with the following items:

  • Completed Patient Forms (see below)
  • Insurance Card
  • Photo ID
  • Medical Records

Your most recent labs and/or reports within the past two years are vital to providing you with a proper evaluation. Please let us know if you need assistance requesting your records from another office.

New Patient Forms
New Patient Packet
Prostate Risk Assessment New Patient Packet
Updates for Existing Patients
Update Packet for Established Patients
Financial Policy and Insurance (Updates only)
Patient Address/Phone (Updates only)
Records Release Form (Updates only)
Credit Card Authorization (Updates only)
Questionnaires and Helpful Links
Diet Diary
Urological Questionnaire (Men’s Health Only)
Homeopathic Questionnaire
Environmental Questionnaire
Notice of Privacy Practice

If you experience any difficulties downloading this form or would prefer to have us fax them to you, feel free to call our office at (602) 493-2273.

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