New Pueblo Medicine Your Physician Team for Life

(520) 290-0300

6365 E. Tanque Verde Rd. Suite #120
Tucson, AZ 85715
Office Hours: 8:00AM - 5:00PM

  • About Us
    • History of Our Practice
    • Certification and Recognition
    • Our Philosophy of Care
    • Patient-Centered Medical Home
    • Benefits of Electronic Medical Records
    • What Our Patients are Saying
  • Our Provider Team
    • Our Team Approach
    • Rodolfo B. Penaflor Jr., MD
    • Mark A. Zaetta, MD, FACP
    • Alok R. Sharma, MD
    • Patrick Noonan, DO
    • David Brower, DO
    • Michael Kevin Mayette, Jr., FNP
    • Casandra Crowson, FNP-BC
    • Elena McCabe, RN, FNP-C
  • Services
    • Primary & Preventive Care
    • Disease Management
    • Laboratory
    • Urgent & Emergency Care
    • Traveler's Clinic
    • Diabetes Management
    • Anticoagulation Clinic
    • Counseling Services
    • Additional Services
    • Video Visits
  • Health Education
    • Health Links
    • Newsletter
    • Community Resources
    • What's New
  • Contact Us
    • Contact Information
    • Career Opportunities
    • Share Your Experience
    • Patient Portal
  • Patient Portal

Patient Forms

You need Adobe Acrobat to view and print these forms. Click here for a free download of their latest version.

  • About Us
  • Welcome Letter for New Patients
  • Appointment Guidelines for New Patients
  • New Pueblo Medicine Fact Sheet
  • New Patient Registration
  • Payment Policy & Office Procedures
  • Patient Bill of Rights
  • Review of Symptoms
  • Emergency vs Urgent Care
  • Medical Records Request Form

If you are scheduled for a New Patient Pre-Registration Telephone Interview appointment, you do not need to print out the forms below.


  • Personal Health History
  • Medication List

Patient Resources

  • New Patient Appointments
  • Established Patient Appointments
  • Pay Your Bill Online
  • Insurance
  • Medicare
  • Forms
  • Referrals
  • Prescriptions
  • Advance Directives
  • Medical Records
  • Billing & Financial Policies
  • Patient Rights & Responsibilities
  • Labs & Radiology Maps
  • Sharps Disposal

Navigate

  • New Pueblo Medicine Home
  • About Us
  • Our Provider Team
  • Services
  • Health Education
  • Contact Us
  • For Patients
  • Traveler's Clinic

Help Desk

  • Patient Portal
  • Career Opportunities
  • Tell Us About Your Visit
  • New Patients
  • Established Patients
  • Insurance Information

Practice Info

  • Terms and Conditions
  • Privacy Policy
  • Non-Discrimination Notice
  • Accessibility statement for individuals with disabilities

Copyright Information

© 2012, New Pueblo Medicine, PC
Medical website design by Omedix