Arizona Provider Forms
Provider Forms & Information
Novo Office Assistant
Please fill out the information form below and someone will assist you. For more information please contact Rodney Woodruff at 801-807-7639.
Patient Transfer Center
The Patient Transfer Center’s one-call system for referring physicians is fast, efficient, comprehensive and user-centered. Calling 855-500-2305 or 602-501-5090 expedites both time-sensitive emergency direct admissions and non-emergent transfers for services at Mountain Vista Medical Center, Tempe St. Luke’s Hospital and St. Luke’s Medical Center.
Hospital Affiliation Letter
Mountain Vista Medical Center is pleased to provide you with a new automated system called Re-Portal to provide quick and accurate on-line affiliation verification. This service is available for all credentialed practitioners that are past and current members of our medical staff. Once your selection is made a letter will immediately print with your hospital name and the information you requested. If you cannot locate a practitioner, please contact Medical Staff Services at 602-251-8193, we will be more than happy to help you.
Medical Staff Resource Center
Mountain Vista Medical Center is pleased to provide you access to our online automated system that will allow you to obtain many medical staff documents. This includes but not limited to the following:
- Application Request Form
- Rules and Regulations
- Standards of Conduct
- Access to initial application
To receive an application for privileges, you must complete an “Application Request Form” and return it to the Medical Staff Office. You will then be provided with a Login Name, User ID and Password which will give you access though this website to the initial application and other supporting documents.
Standing Admission Orders
- Acute Coronary Syndrome (AMI/Chest Pain)
- Atrial Fibrillation
- Cerebral Vascular Accident
- Chronic Obstructive Pulmonary Disease
- Deep Venous Thrombosis
- Diabetic Ketoacidosis/Uncontrolled Diabetes
- Gastrointestinal Bleed
- Heart Failure
- Hypertension/Hypertensive Crisis