Scheduling an Appointment

For your convenience, we will try to arrange your office visits for times that fit your schedule. Please complete as much of the form as possible, then click the Request Appointment button at bottom of this page.

Note: If you have a emergency, please call 1-480-874-BABY (2229).

Please use this form for appointment scheduling purposes only. DO NOT send personal health information through the form below. Specific patient care questions must be addressed with your doctor during an appointment. For more information about how your personal information is protected by this office, please read our Privacy Notice.

Full Name:

Email Address:

What times and days of week are convenient for you?

Will this be your first visit to Advanced Fertility Care, PLLC

Yes   No

Home Phone:

Work Phone:

Cell Phone:

How did you hear about our practice?

Use area below for referrals or other comments:

We check our email several times a day and will usually reply in 24 hours or less.