We have worked extensively and deliberately to create a form that will provide us with a comprehensive health history to last the longevity of your time with our practice.

We appreciate the time and thought you contribute in filling out the forms. This information will allow us to care for you in an informed, thorough, and safe manner. Lastly, but no less important, it will help us learn something about you, your concerns, and your interests, so that we may treat you in a caring, personal way, taking all this information into consideration as we make recommendations and prepare an individualized treatment plan.

Questions? Email or Call Us at 520-323-7100


  • Download & Print
  • Upon completion, please submit the form to us in one the following ways:
  • Fax
  • 520-323-2228
  • Attach and Email
  • info@drpeterkay.com
  • Drop Off
  • 2355 N. Wyatt Drive, #111 Tucson, AZ