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Patient Forms

Instructions

Once you sign and complete the forms needed for your appointment, do one of the following:

  • E-mail it to us at healthservices@boisestate.edu

    Disclaimer: The Health Insurance Portability and Accountability Act (“HIPAA”) recommends that E-mail that contains protected health information, such as medical records or sensitive health information, be encrypted. E-mails sent to and from Health Services are not encrypted, so E-mails may not be secure. Therefore, it is possible that the confidentiality of such communications may be unintentionally disclosed to a third party.
  • Fax it to us at (208) 426-3005
  • Bring it with you to your next appointment and hand it to one of our front desk staff
  • Medical Records and Release of Information can be faxed to (208) 426-4059 or email medicalrecords@boisestate.edu

Medical New Patients Paperwork

Counseling New Patients Paperwork

Massage Paperwork

Patient Portal

Patient Portal User Consent Form

Medical Record Release

Appeals/Complaints

Account Maintenance Appeal

Notice of Privacy Practices

Notice of Privacy Practices

Self Pay Agreement

Self Payment Agreement 2024