Patient Forms

The following forms and corresponding instructions have been provided for your convenience. Please note that these forms may not be the appropriate forms for all patients in all circumstances.

Patient Forms

New patients can save time during their first appointment by completing the Patient Registration form prior to their visit. Simply print out the Patient Registration form, fill in the information requested, and bring the completed form with you to your appointment.

Debe usted completar el registro del paciente antes de su primer cita. Necesita usted impremir el registro del paciente, completarlo, y traerlo a su cita.

 

To have medical records released, please complete the Authorization to Release Medical Information form and mail to PO Box 191050, Boise, ID 83719, ATTN: Medical Records. You can also fax the completed form to (208) 955-6502, ATTN: Medical Records. Questions regarding the release of medical information can be addressed to Medical Records Coordinator, at (208) 955-6498 or records@primaryhealth.com.

Confused about what immunizations your health plan covers? This helpful checklist will guide you through the conversation with your health plan before your next visit if it may include immunizations.

 

Specialist Forms


Pediatrics


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