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.

Info Form

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.

Access Letter

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
  • Bylaws
  • 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.

Access Center