Patient Forms
NEW MEMBER FORMS – CLICK TO DOWNLOAD
Membership Agreement
Code of Conduct
Consent to Unecrypted PHI
Consent for Ongoing Treatment
Consent for Telemedicine
Notice of Privacy Practices
Medicare Contract (only for patients with Medicare)
OTHER FORMS – CLICK TO DOWNLOAD
Record Release Form
Record Request Form
Membership Termination Form
PATIENT PAYMENT PORTAL
To access our patient payment portal please click here.
Contact
Contact Us Today
Phone and Email
Hours
Closed
ADDRESS
3624 North Centrepoint Way, Suite 100
Meridian, ID 83646
Just north of Hobby Lobby.