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.
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