12647 W. Smokey Dr, Ste #119, Surprise, AZ 85378 Mon–Fri: 8:00am – 5:00pm

Patient Information

Everything you need to know before your visit — office hours, insurance, forms, and policies.

Patient Forms

To save time on the day of your appointment, please fill out the appropriate forms below and bring them with you. Forms require Adobe Acrobat Reader.

Patient Registration Form

Required for all new patients before your first visit.

Download

Medical Record Release — Dr. Dhupati

Authorize the release of your medical records to or from Dr. Dhupati's office.

Download

Medical Record Release — Dr. Ariff

Authorize the release of your medical records to or from Dr. Ariff's office.

Download
Documents are in Adobe PDF format. Download Adobe Reader free at adobe.com if needed.
Scheduling & Cancellation Policy

If you are unable to keep your upcoming appointment, we ask that you give us at least 24 hours notice so that we can use that time for someone else who may have an urgent need.

It is possible that your appointment could be delayed or rescheduled if the doctor has to leave the office for an emergency. We will do everything possible to still see you that day or fit you into the schedule at another time.

Same-day appointments are available for urgent medical needs — please call us as early in the day as possible.

Payment & Financing Options

Payment for professional services can be made with cash, check, or major credit cards.

Parkview Internal Medicine firmly believes that a good physician/patient relationship is based on understanding and good communications. If a patient feels that he or she may require financial assistance, please notify the practice receptionist before you see the physician.

Patients who do not have insurance are expected to pay for professional services at the time of service unless prior arrangements have been made with us.

Cash Check Visa / Mastercard American Express
Accepted Insurance Plans

Parkview Internal Medicine accepts most major insurance plans. For patients who are members of these plans, our office will submit a claim for services rendered. The patient must complete all necessary insurance information before leaving the office.

Aetna
Aetna Medicare Advantage
AHCCCS
AP IPA
AARP
Blue Cross Blue Shield
Banner Health Employee Plan
Banner Medicare Advantage
Banner Aetna Plan
Beech Street
Cigna Commercial Plans
Cigna Medicare Advantage
Devoted Medicare Advantage
Great West
Humana Medicare Advantage
Health Net Medicare
Mercy Care
Railroad Medicare
SCAN Health Plan
United Healthcare (multiple)
This is a partial listing. Insurance participation may change. Please call 623-544-1700 to confirm your specific plan before your visit.
What to Bring to Your Appointment
  • Photo ID (driver's license or state ID)
  • Insurance card(s)
  • Completed patient registration form (if new patient)
  • List of all current medications, including dosages and supplements
  • Any relevant medical records, lab results, or imaging from other providers
  • Referral paperwork, if required by your insurance
  • List of questions or concerns you want to discuss
  • Co-pay or payment method (cash, check, or credit card)