Before your appointment with us, quickly and conveniently access patient forms from our practice.
New Patient Registration
To view the forms listed below, you will need the latest version of Adobe Reader.
You may download Adobe Reader for free at www.adobe.com. Please bring your completed forms with you to our office at the time of your visit.
Behavioral Health Forms
- Notice of Privacy Practices
- Acknowledgement receipt of Notice of Privacy Practices
- Request for Amendment to Personal Health Information
- Medical Records Release
For your convenience we are contracted with the following Insurance Companies
* (please contact your insurance company for in-network details)
Blue Cross of Idaho
Regence Blue Shield of Idaho
Carriers through IPN-Aetna, Great West, ODS, AIG, Assurant, Coresource, EBMS, Everest, First Administrators, Humana, Meritain Health, Nesika, MS Administrators, Mountain States Admin, P5 Health Plan, Riverside Benefit, Smith Administrators, Starmark, TPM Trust, UMR, Cigna, United, Ameriben, Pacific Source, etc.
Bright Path-Through Select Network
Micron Health-DAS (Dakota Care)
First Choice Network