Please click on the desired link below to download a pdf version of our forms.
- New Patient Information Packet
- Record Release Form
- Protected Health Information Release Form
- HIPAA Privacy Acknowledgment Form
- Laboratory Testing Instructions
- Treadmill Stress Test Instructions
- Treadmill Release Form
- Mail order Rx Instructions
1/30/18 Update: We have a limited number of Flu Shots remaining. Please call the office for an appointment if you haven’t already received your Flu Shot.
To: IMA Patients
Subject: Pneumonia Vaccination Information
The Advisory Committee on Immunization Practices (ACIP) now recommends
Prevnar 13 for specific adults aged 65+
Patients who are 65 years of age or older are at increased risk for pneumococcal pneumonia. Risk increases even further for patients with the presence of chronic conditions such as Diabetes, Cardiovascular Disease and Chronic Pulmonary Disease.
The new PVC13 (Prevnar) vaccine is now available at our office. It has been shown to be “significantly effective” against community acquired pneumonia.
Please see the below links for detailed information on the vaccine:
Due to the complex information outlined in the link to the Centers for Disease Control website, we have summarized the recommendations below.
You should consider getting the PVC13 vaccine if:
Aged 65+ and have never had ANY pneumonia vaccine
Aged 65+ and had your last pneumonia vaccine over 1 year ago
If you have questions as to whether or not you are eligible for the vaccine, or if you wish to schedule your vaccination, please call our office at 602-522-1900.
This vaccine is covered 100% by Medicare Part B.
We currently have the vaccination available to you here at our office.
Wayne E. Kuhl, M.D. Jeffrey A. Nebelsieck, M.D.
Gregory J. Johns, M.D. Tamara H. Lieberman,M.D.
Laura K. O’Malley, M.D. Rebecca Rowen, P.A.
Staff of Internal Medicine of Arizona
December Lunch Sign up Link: https://www.signupgenius.com/go/10C094CA9AC2AA7FD0-december1
January Lunch Sign up Link: https://www.signupgenius.com/go/10C094CA9AC2AA7FD0-january1