The Medical Office of A. A. Emami, D.O., M.D., F.H.U., F.A.C.O.I.
Board Certified Internal Medicine
Fellow, Hospitalist's Union
Fellow, American College of Osteopathic Internists
Former Certified Personal Trainer, American College of Sports Medicine (A.C.S.M.)

8080 East Gelding Drive
Suite D-101
Scottsdale, Arizona 85260

Phone*:                    480.508.0541

Facsimile:                    480.508.0542
E-Mail**:  info@menshealthaz.com

Men's Health Care Patient Forms

If you are a new patient to Men's Health Care, please read or download, print and complete:
*****to ensure proper printing, please download PDFs from your browser then print rather than printing directly from your browser.
*****please print forms on one side only (not double sided).


1.  NEW PATIENTS:

  • FORM A INSTRUCTIONS.   (It is not necessary to print this form.  Read:  Fill out FORM A after reading this form).
  • FORM A.   (Download, Print and Complete:  Fill out this form after reading FORM A INSTRUCTIONS).

  • FORM B INSTRUCTIONS.   (It is not necessary to print this form.  Read:  Fill out FORM B after reading this form).
  • FORM B.  (Download, Print and Complete:  Fill out this form after reading FORM B INSTRUCTIONS).

  • FORM C INSTRUCTIONS.   (It is not necessary to print this form.  Read:  Fill out FORM C as you read this form).
  • FORM C.  (Download, Print and Complete:  Fill out this form as you read FORM C INSTRUCTIONS).


2.  RETURNING PATIENTS:

  • FORM D.  (Download, Print and Complete).


3.  ALL PATIENTS (NEW AND RETURNING) HAVING THEIR ANNUAL PHYSICAL EXAMINATION:

  • FORM E.  (Download, Print and Complete).


4.  Miscellaneous Forms:

*ANSWERING SYSTEM DISCLAIMER:

Please note, Men's Health Care does not check voice messages on this answering system, but feel free to e-mail Men's Health Care.


**E-MAIL DISCLAIMER:

Men's Health Care cannot and will not guarantee the security of e-mails being sent and received. We do not and cannot make any guarantees regarding prevention of access to, or prevention from diversion of information by third parties such as hackers, malware, viruses, etc. Please note, the risk of third party access to the e-mail exchange is no greater than or less than any other e-mail that is being sent or received. Men's Health Care cannot and will not be held liable for any damages that may result from unauthorized access to information that is transmitted. If you are concerned about your information being accessed, please do not e-mail info@meanshealthaz.com, rather call our office for information. If you do not understand the risks and the release of liability above, please do not e-mail info@menshealthaz.com, rather call our office for information. If you do e-mail info@menshealthaz.com, we will interpret this as you understanding the risks and the release of liability above. In our correspondence, we will transmit the minimum amount of personal information required to reply to your e-mail.


LEGAL DISCLAIMER ON ONLINE MEDICAL ADVICE:

If you believe you have a medical emergency, you should immediately call 911 or your nearest Physician or go the nearest hospital's emergency department.

This site is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment, or services to you or to any other individual. The information provided in this site is not a substitute for medical or professional care, and you should not use the information in place of a visit, call, consultation or the advice of a Physician or other health-care provider. Men's Health Care is not liable or responsible for any advice, course of treatment, diagnosis, or any other information, services or product you obtain through this site.

If you believe you have any other health problem, or if you have any questions regarding your health or medical condition, you should promptly consult your nearest Physician or other health-care provider. Never disregard medical or professional advice, or delay seeking it, because of something you read on this site. Never rely on information on this website in place of seeking professional medical advice. You should also ask your nearest Physician or other health-care provider to assist you in interpreting any information on this site or in applying the information to your individual case.

Medical information changes constantly. Therefore the information on this site should not be considered current, complete, or exhaustive, nor should you rely on such information to recommend a course of treatment for you or any other individual. Reliance on any information provided on this site is solely at your own risk.

Please note, the medical care offered by Men's Health Care should not be construed as an emergency service. Men's Health Care's hours of availability do vary. Please call the office for further information and for the latest updates on availability of services.