Forms:

 

Patient Intake form:

 

If you are interested in information about our patient portal please

call 406-314-4477 to obtain your login information.

 

If you prefer to complete your intake information in paper form please print this document and bring it to your appointment.

 

 

Record Release Form: Request that your records be transferred to us from another provider.

 

 

 

Minors:

 

Minor Policy:  It is our policy that minor patients under the age of 18 must be accompanied by a parent or legal guardian for initial visits. This in the best interest of all parties, so that we may discuss treatment and/or procedure options for the patient.  We understand that work schedules can make it difficult for guardians to be present for all appointments, so follow-up appointments without a guardian may be considered with an appropriate minor release form.  However, treatment changes or additional work-up may be deferred at discretion of the provider, if a guardian is absent. This is for the safety of the minor and we apologize in advance for any inconvenience this may cause. If a minor is seen without a guardian they are responsible to convey information discussed at the appointment.

 

 

DOWNLOAD MINOR CONSENT FORM HERE:

 

 

NOTICE OF PRIVACY PRACTICE

 

 

 

1600 Whitefish Stage, Suite #1, Kalispell, MT 59901

Phone: 406-314-4477   |   Fax: 406-558-2844

Hours: 8:30am - 5:00pm Monday - Friday