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Patient Forms

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iStock_000006146968Small_sm_borderProspective patients can download important forms and complete them prior to your first visit.

  • New Patient Form
  • Patient Information and Practice Policies
  • Consent for Treatment
  • Medical Records Request from Other Practice or Provider to MIM
  • Medicare Notice of Noncoverage ABN
  • Privacy Practices Patient Acknowledgement
  • HIPAA Notice of Privacy Practices
  • Directions to Mountain Integrative Healthcare

Please  contact me if you have problems downloading the documents.

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