Patient Registration

If you are seeing Dr. Izadi for the first time or you are an established patient seeing Dr. Izadi for a new problem, please come to your appointment at least 15 min early to complete the necessary paperwork. To minimize your wait time during the visit, bring the following documents to your appointment:

1. Fill out and print the MD West ONE Patient Registration and Medical History Form below

2. Any medical records pertaining to your current condition
3. Any studies (X-ray, MRI, CT, nerve studies) with reports pertaining to your current condition 
4. Insurance card 
5. Valid ID

You do not need to bring this form to your appointment, however please review:

• View MD West ONE Notice of Privacy Practices
• View MD West ONE Financial Policy

If you have any questions regarding the forms, please contact Dr. Izadi’s office at (402) 390-4111.