Forms

Ancillary Services Form - Use to order outpatient Laboratory, Cardiology and Imaging procedures at Flagstaff Medical Center.

Remote Access to FMC network - For physicians and physician office staff. Provides access to Cerner PowerChart and Philips iSite (PACS system-FMC Radiology images) in your office or from home.

Physician Directory Profile Form - Submit your FMC Physician Directory profile, to appear on fmcdoctors.com.

Continuation of Care - Release of Information
This form is intended for use by other medical offices and facilities for the purpose of providing information for continuation of care. This form is NOT for patient use, Legal or Insurance requests for information.