Weather Notice: Primary Health clinics may close early on Wednesday, July 24th in the case of inclement weather leading to power outages.

Forms

Woman filling out a form, or forms, on a clipboard

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.

Coronavirus (COVID-19) Information

New 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. 

Document Upload

Document Upload should not be used to submit medical records requests. Use the form to send copies of documents to your clinic. This may include insurance cards, test results from other healthcare providers, etc.

Formas en Español 

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.

Telehealth Visits

Wellness and Routine Exam Forms

Patients seeking a routine preventive exam (annual physical) should read the Routine Preventive Exam document below before their appointment.

Medical Records Request

To have medical records released, please complete the Authorization to Disclose Protected Health Information form and mail to PO Box 191050, Boise, ID 83719, ATTN: Medical Records. You can also fax the completed form to the patient's clinic, 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. Please do not submit your medical records request through this site's Document Upload feature.

Immunization records can be printed directly from the Patient Portal

Submit Medical Records 

Patients may email their own medical records to us at records@primaryhealth.com. Please note that using this website to email your records is not secure.

Immunizations 

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.

Additional Forms

Specialist Forms

Pediatrics

Occupational Health

Formas de Occupational Health en Español

*Employers, please use the Treatment Referral Form when sending your employees into our clinics for drug and alcohol testing. Using this form increases our ability to perform the correct services for you and your employees. If you would like a custom form made specifically for your company’s needs, please contact the Occupational Health department.

Contact us today to learn more.