Health History
Insurance Information
Privacy Practices

Only the first two forms (Health History and Insurance Information) need to be filled out. The Privacy Practices form is for your reference and information only. It does not need to be brought into the office.

Contact Us

1075 S. Idaho Rd.
Suite #105B
Apache Junction, AZ 85219
Phone: (480) 380-5116
imageeye@imageeyecareaz.com