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All Information MUST BE COMPLETE in Order to Process Referral PATIENT INFORMATION: Main number (602) 9331213 Radiology Scheduling (602) 9331215 Fax: (602) 9331214 Interventional Scheduling (602) 5464444.

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As the largest pediatric hemophilia program in the state, we provide care for patients until age 21, and for certain programs, we treat adults too.

Patients are eligible for services, regardless of insurance status and/or ability to pay. There is no charge for services, they are free.

Phoenix Children's is one of the largest children's hospitals in the country with 433 licensed beds. Inpatient services are available on the main campus and at Dignity Health Mercy Gilbert Medical Center, which offers 24/7 hospitalist coverage for East Valley families.

Phoenix Children's Hospital (PCH) and Phoenix Children's Medical Group (PCMG) proudly participate with all AHCCCS ACC plans, with the sole exception of Centene's Arizona Complete Health.

Please complete all areas on the form and if you have questions, please contact the Health Information Management Department (Medical Records at 602-933-1490 Option 1).

Members of the news media wishing to contact or interview a Phoenix Children's physician, nurse, staff member or patient family should email mediarelations@phoenixchildrens.com or call 480-798-5951 to reach the on-call Communications representative.

Requesting Patient Medical Records To receive your child's medical records, you must complete the authorization form: Medical Records Request & Authorization (PDF) Autorización Para Divulgar Información Protegida de Salud (PDF)

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232