Our staff may request that you download these forms in anticipation of your visit. Please complete these forms and sign them by your first visit.
Note: Medicaid requires that all Medicaid patients must fax or mail a copy of their Healthy Connections Referal Form and a copy of their latest physical exam BEFORE their first visit. Call your doctor to request that these are sent to us. Our fax number is 208-378-1142.
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| 1b) (Read only; print 1a and sign) |
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| 5) (Only for marriage/couples counseling) |
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| 6) (Only for marriage/couples counseling) |
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| Non-Required: Policy, Programs, and Information |
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| Creative Writing by Mrs. Rice, Owner |
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