Telemedicine New Patients

Please upload a copy of your ID, Insurance Card, and New Patient Forms below. These must be received prior to your appointment, otherwise you may have your appointment cancelled. If you cannot upload your ID or Insurance Card you can fax a copy to 602-419-3101

Please upload your ID and insurance card. 

If you are self pay, only upload Picture ID.

Upload Picture ID
Max File Size 15MB
Upload Forms
Max File Size 15MB
Upload Insurance Card
Max File Size 15MB
Contact

Send us a message

A staff member will reply as soon as possible

Please do not send any personal Health Information

CALL THE OFFICE 480-247-7476 IF YOU NEED TO SPEAK WITH A STAFF MEMBER REGARDING PRIVATE HEALTH INFORMATION 

    Southern Avenue Medical Center

    2034 East Southern Ave. Suite D

    Tempe, Arizona 85282

    ​​Tel: 480-247-7476

    Fax: 602-419-3101

    Billing: (855) 689-8166 or patientbilling@kareo.com

    i​nfo@aleveamentalhealth.com

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    Arizona State University

    hotline

    (480) 921-1006

    Empact Suicide Line

    24 hours / 7 days (480) 784-1500 

    © 2017 ALEVEA Mental Health. All Rights Reserved