Below is a list of the documents and forms for our patients.
All files are in Adobe’s Acrobat format.

pdf  New Patient-Form English
pdf  New Patient-Form Spanish

pdf  Sleep Questionnaire English
pdf  Sleep Questionnaire Spanish



You will need to bring your insurance card and a photo ID. If you have any previous medical records please bring them. The doctor will need a list of all your medications including the dosage and how you take them. Make a list of all your concerns so that you may discuss them with the doctor.

If this is your first visit to Sleep Center of Yuma, we recommend that you download the forms, fill them out and bring them to the office. It takes the doctor time to review the patient's history.


Please plan to arrive at least 15 minutes early to complete your registration. You will be asked to sign our HIPAA form, as required by law, so that you are aware of our privacy policies.


During the visit, you will meet with the staff, complete a few brief forms, and of course meet your doctor. You will be asked to provide us with personal information such as your insurance cards and Photo ID. Once your medical record has been updated the medical assistant will greet and escort you to a private room for a brief history. He will also check your height, weight and blood pressure. The doctor will review with you the health history and discuss your current medical issue. The rest of the exam is dedicated to detect the cause of the problem and prescribing treatment.

The visit is not just an opportunity to deal with any medical concerns you may have but also a time answer any of your questions.


Be prepared to pay your deductibles, co-pays, co-insurance and any other amounts due at the time of your visit. As a courtesy, we will bill your insurance company for you. However, it is your ultimate responsibility to know what your insurance does or does not cover. It is impossible for our office to know what your personalized benefits are. If you have questions regarding your coverage or responsibilities, please direct your call to your insurance carrier.

If you have any changes in your insurance or demographic information, it is extremely important that you notify our office as soon as possible. Having the wrong information causes not only a delay in the billing process, but can also delay any other communications that our office may need to pass on to you.


  • 2110 West 24th Street,
    Yuma, AZ 85364
  • Call Us:  (928) 726-7106
  • Fax:  (928) 726-6306