Patient Information

FOR NEW PATIENT FORMS – Please print all forms.
(Patient must update forms if they have not been seen at our clinic in the last three years.)

Patient Check in Forms

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Authorization for release of patient health information 

 Records Release Form

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PARTICIPATING NETWORKS

This is not an inclusive list and an insurance provider listed here does NOT guarantee participation,
please contact your insurance carrier directly to verify our participation status with your insurance.

Blue Cross of Idaho, Traditional ,PPO

Regence Blue Shield, Traditional, PPO

Idaho Physician’s Network, SelectHealth,  BrightPath, MT Health Co-OP,United Health Care, Ameriben, PacificSource, Aetna, Great West, Cigna, ODS, Idaho Medicaid, Triwest/Tricare, and Medicare Participating providers.

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