Intake Forms

Are you new to Desert Dove? Save time by downloading and filling out the following documents before coming in for your first appointment. Questions? Call 480-899-3683

  1. New Client Information Form
  2. Symptom Survey Form
  3. Desert Dove Health Alliance Membership Contract

Every New Client Please Read This Formula

In order for you to be successful in your healthcare at this office

consider the Gliecher Formula:

C = ABX > D

A = Clarity of your desired future state.  Your goal, your intention, your chief aim, where you want to be in 6 months to a year.

B = Practical first steps.  The action steps you must take to reach your goal, inspired actions and the mechanisms that will make this possible.

X = The level of dissatisfaction with your current state, ie. your body, your relationships, your finances, your health, your business etc.

D = Personal cost to change.  (1.)  Giving up old, outdated, inaccurate, ineffective, self destructive – beliefs, habits, people, places, experiences or events, memories, imaginations and vices . (2.)  Embracing new beliefs, new virtues, new people, new places, new circumstances, new events etc.

C = Change

* The change (C) you desire will occur in reality when the product of ABX is greater than D.

Are You WILLING to heal?  Only you can answer this.  I can help with A and B.  You must consider X and D.

We look forward to helping!  Call us when you are certain that you care willing to BE and DO what it takes to HAVE what you want.

In Health & Service,

Dr. Roland F. Phillips Jr., and Staff