We want to make sure we have everything we need to take great care of you! To do so, we ask that our new and returning patients help us update their records. When you come for your visit with us, please bring your photo ID, insurance card (if applicable), and any new prescription information (bringing your current prescription bottles is perfect!). To help make your check-in process as smooth and quick as possible, we’ve made our forms available right here.  Simply print them, fill them out in the comfort of your own home and bring them with you!

If you have any questions about the forms, please call our office at (208) 528-7655. Thank you for choosing us for you care, and we are excited to assist you!

Patient Forms - Medical

Patient Forms - Dental

Sliding Scale Discount paperwork

We want to  make care affordable for everyone! If you would like to apply for our Sliding Scale Discount — which is base on your family size and household income — please print and fill out our application. To qualify for the Sliding Scale Discount, please submit your proof of household income along with the application within 30 days of your visit. If we do not receive proof of income within your set timeframe, we will have to bill you for the full amount.

Proof of Household Income Options

Anyone is welcome to apply for our Sliding Scale Discount, regardless if you have insurance or not! We just ask patients to provide one of the following:

  • Income Tax Return for Previous Year
  • Complete Paystubs for last month (30 days)
  • Bank Statement for last month (30 days)
  • Work Verification Letter, Termination of Employment Letter, Indigent Letter, Medicaid Denial Letter.
  • Award Letters for any Public Assistance:
    • (Food Stamps, Income from Dividends, interest and/or rent, Social Security Benefits, Disability, Alimony, Unemployment Compensation, Farm or Self Employment, Child Support, Pensions, Grants, Workman’s Comp, Veterans Benefits)