Forms & Payment
Accepts new patients
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Medical insurance plans and payment options
Aetna, Arizona Foundation Medical Care, ASPA, Blue Cross Blue Shield, Beech Street, Cigna All Lines of Service, Great West, Healthnet, Lifewise, One Health Plan, Private Health Care System, Prudential, United Healthcare All Lines of Service
Credit Cash
Office information from Duane D H Pitt, MD
HIPAA Policy Registration-HIPAA Privacy AcknowledgementPlease complete prior to your first visit.
Controlled Medication Protocol Medical Records Release Form
Please read and sign if you would like us to release or obtain records from anyone.
New Registration- New Patient Questionnaire (Adobe)
This questionnaire must be completed in full prior to your first office visit with the other registration material listed. Please print these forms from your browser. If you are unable to print these forms, arrive for your appointment 45min early to complete all forms and regestration.
New Registration- New Patient Questionnaire (MS Word)
This questionnaire must be completed in full prior to your first office visit with the other registration material listed. Please print these forms from your browser. If you are unable to print these forms, arrive for your appointment 45min early to complete all forms and regestration.
Oswestry Questionnaire
Please complete only if you are being evaluated for low back issue. For Scoliosis, please see SF-36.
Registration-Acknowledgment Form
Please complete prior to your first visit.
Registration-DISD Registration Form
Please complete prior to your first visit
Registration-Research Release Form
Please complete prior to your first visit.
SF-36 Questionaire
Complete only if you are being evaluated for Neck issues or Scoliosis.
Contact Information
Desert Institute for Spine Disorders
8573 E. Princess Dr. Suite #221
Scottsdale,
AZ
USA
85255
View map
Phone (480) 656-4048
Fax (480) 247-6146
Other staff in my practice
Billing/Collections: Cynthia Vanderwerp
CVanderwerp@spinedisorders.net
Scheduling/Front Office: Darcy Mckinney
DMckinney@spinedisorders.net
Medical Assistant: Trinette Anderson
TAnderson@spinedisorders.net
Front Office: Tammy Lucas
TLucas@spinedisorders.net
They have a great deal of experience, and you will find them pleasant and helpful. If you have any questions, you can leave a message for my staff at (480) 656-4048. Your call will be returned within 1-2 business days. Please allow 48 hours for medication refills.
Desert Institute for Spine Disorders, PC
8573 E. Princess Dr. Suite # 221 Scottsdale, AZ 85255
CVanderwerp@spinedisorders.net
Scheduling/Front Office: Darcy Mckinney
DMckinney@spinedisorders.net
Medical Assistant: Trinette Anderson
TAnderson@spinedisorders.net
Front Office: Tammy Lucas
TLucas@spinedisorders.net
They have a great deal of experience, and you will find them pleasant and helpful. If you have any questions, you can leave a message for my staff at (480) 656-4048. Your call will be returned within 1-2 business days. Please allow 48 hours for medication refills.
Desert Institute for Spine Disorders, PC
8573 E. Princess Dr. Suite # 221 Scottsdale, AZ 85255
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