New Patient Paperwork

Revitalize Weight Loss & Wellness Center offers our patient form(s) online so they can be completed in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them.
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring them with you to your appointment.
Revitalize Weight Loss & Wellness Center Weight Loss Guarantee

OFFICE HOURS


Monday
Closed


Tuesday
7:30am - 6:30pm


Wednesday
7:30am - 6:30pm


Thursday
7:30am - 6:30pm


Friday
7:30am - 6:30pm


Saturday
8:00am - 3:00pm

Revitalize Weight Loss & Wellness Center
5355 West Chandler Boulevard #7
Chandler, AZ 85226
(480) 435-3557