East Valley Wellness Center
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Merck Engage
A free, online resource which includes healthy recipes, ideas for getting fit, and practical planning tools for better health.

Monthly Health Tip:
 Why do I need a first aid kit in Arizona? Falls, bee stings, burns, allergic reactions -- all of these are common accidents that can happen in any home or on any outing. That’s when a first

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Patient Forms

Please feel free to download and complete the following forms at your convenience.  It can help speed the check-in process if you have them completed upon your arrival.

If you are a current patient, we ask that you update these every six months.  If you are a new patient, you may download our registration forms in advance, then bring the completed forms with you when you come in for your appointment. East valley Wellness, Gary Smith, Gilbert Family Doctor, Forms

Patient Registration
Financial Policy
Adult Health History
Pediatric Health History 
Permission to Release Private Health Information
Medical Records Release Authorization (as needed)


These forms require Adobe Reader. If you do not have Adobe Reader, you may download it free here.


East Valley Wellness Center Family Practice

7400 S. Power Road, Bldg. 5, Ste. 120 • Gilbert, Arizona 85297
P: 480-988-1659 F: 480-988-1871


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