Schedule an Appointment at Sonoran Spine | Appointment Request Form

Request an Appointment

To schedule an appointment for yourself, please complete all of the information requested in the form below. Please note that the asterisk (*) items are required to complete your appointment request.

Once your request has been submitted, we will contact you within 24 hours (Monday – Friday) to schedule an appointment with your chosen provider and location.

Referring a patient from your practice to Sonoran Spine? Use our Patient Referral Form. Requesting an appointment for a work related injury? Use our Workers’ Compensation Appointment Form.

We look forward to continuing to provide the expert care our patients have come to expect from Sonoran Spine.

Patient Information

Full Name:*

Date of Birth:

Address 1:*

Address 2:

City:*

State:*

Zip Code:*

Best Number to Contact You:*

Email Address:*

Primary Care Physician:*

Have you ever been seen at Sonoran Spine?* Yes No

Appointment Details

Please note that not all providers are available at every location. We will follow up with patients regarding their provider and location preferences.

What problem will we be evaluating?*

Please give a brief description of your problem:*

Have you ever been evaluated for this problem before?* Yes No I don't know

Will you be bringing any imaging films with you? (Check all that apply.)* X-Rays MRI CT None

Preferred Office Location:*

Preferred Provider:*

Insurance Information

Primary Insurance:*

Member ID#:

ReCaptcha

Gilbert
3717 S. Rome St, Ste 106, Gilbert, AZ 85297

Glendale *Updated Address*
6206 W. Bell Rd., Ste 4, Glendale, AZ 85308

North Phoenix
33300 N 32nd Ave, Ste 205, Phoenix, AZ 85085

North Scottsdale (Thompson Peak)
20745 N. Scottsdale Rd, Suite 105, Scottsdale, AZ 85255

Queen Creek
37200 N. Gantzel Rd., Ste 240, Queen Creek, Arizona 85140

Scottsdale (Osborn) *New Location*
7242 E. Osborn Rd Suite 230, Scottsdale, AZ 85251

Scottsdale (Shea)
9700 N. 91st St, Ste B108, Scottsdale, AZ 85258

Show Low
4830 Hwy 260, Suite 103, Lakeside, AZ 85929

Sonoran Spine in Collaboration with Honor Health Tempe
1255 W Rio Salado Pkwy, Ste 107, Tempe, AZ 85281

Ph (480) 962-0071
Fax (480) 962-0590

Quick Links

More Information

Ph (480) 962-0071Fax (480) 962-0590

Quick Links

More Information

Ph (480) 962-0071
Fax (480) 962-0590