NEW PATIENT INTAKE FORM

To ensure a seamless and personalized experience, our practice kindly requires a referral or prior approval from Dr. Schulte's office. Please call our office for verification at (480) 451-3454.

Additionally, payment is requested upfront to help streamline your visit. Rest assured; we’ll provide you with a superbill so you can easily submit it to your insurance for reimbursement.


Please select either the online form or the downloadable form, based on the state in which you reside.

ARIZONA -NEW PATIENT INTAKE FORM

Arizona residents who prefer to complete the form online may do so by clicking the button below. 
New patients residing in Arizona who prefer to complete the form manually can download it using the link below.   

CALIFORNIA-NEW PATIENT INTAKE FORM

  IMPORTANT NOTICE FOR NEW PATIENTS IN CALIFORNIA  


We’re committed to supporting your health and wellness needs with care and professionalism.

Please note that, due to California law, Dr. Schulte cannot prescribe benzodiazepines or stimulants to patients in California. This is in accordance with the California Health and Safety Code, which regulates controlled substances to ensure public safety and health. Specifically, benzodiazepines are classified as Schedule IV drugs, and stimulants fall under Schedule II, both of which are subject to strict regulations.

If you have any questions or concerns, feel free to reach out to our team.

California residents who prefer to complete the form online may do so by clicking the button below.
New patients residing in California who prefer to complete the form manually can download it using the link below.   

MASSACHUSETTS-NEW PATIENT INTAKE FORM

Massachusetts residents who prefer to complete the form online may do so by clicking the button below.
New patients residing in Massachusetts who prefer to complete the form manually can download it using the link below.